CAJ | 학술논문

目的探讨胃肠道恶性黑色素瘤的诊治方法,提高诊治水平.方法总结1965年7月至2007年6月收治的70例胃肠道恶性黑色素瘤患者的临床资料.结果 70例患者中男性27例,女性43例,年龄25～75岁,中位年龄53岁,其中50例发生于直肠,10例发生于肛管,10例发生于食管.1、3、5年生存率分别为48.3%、14.6%、6.5%,中位生存时间为379 d.63例接受手术治疗,单纯手术的25例患者和术后辅助化疗、放疗、生物治疗等综合治疗的38例患者的总生存率无统计学差异,Ⅲ期患者综合治疗组较单纯手术组生存率显著升高.风险因素分析提示病变深度为胃肠道恶性黑色素瘤的危险因素.结论手术加综合治疗能提高Ⅲ期胃肠道恶性黑色素瘤的生存率;病变深度是影响生存率的风险因素.
목적 탐토위장도악성흑색소류적진치방법,제고진치수평.방법 총결1965년7월지2007년6월수치적70례위장도악성흑색소류환자적림상자료.결과 70례환자중남성27례,녀성43례,년령25～75세,중위년령53세,기중50례발생우직장,10례발생우항관,10례발생우식관.1、3、5년생존솔분별위48.3%、14.6%、6.5%,중위생존시간위379 d.63례접수수술치료,단순수술적25례환자화술후보조화료、방료、생물치료등종합치료적38례환자적총생존솔무통계학차이,Ⅲ기환자종합치료조교단순수술조생존솔현저승고.풍험인소분석제시병변심도위위장도악성흑색소류적위험인소.결론 수술가종합치료능제고Ⅲ기위장도악성흑색소류적생존솔;병변심도시영향생존솔적풍험인소.
Objective To investigate the diagnosis and treatments of malignant melanoma in gastrointestinal tract. Method The clinical data of 70 cases of malignant melanoma in gastrointestinal tract treated between July 1965 and June 2007 were collected and analyzed. Results There were 27 male and 43 female patients in this group with a median age of 53 years. The melanoma arose from rectum in 50 cases,from anus in 10 cases and from esophagus in 10 cases. The overall 1,3,5 years survival rate were 48.3%,14.6% and 6.5%,respectively,the median survival time was 379 days. Sixty-three cases received operations with or without adjuvant therapy after the operation. There was no significant differences in overall survival rate between the 25 cases received operation only(Group 1) and 38 cases supplemented by adjuvant therapy after operation(Group 2);whereas,the cases with clinical stage Ⅲ tumor in Group 2 had significantly better survival than their counterparts in Group 1. It was found that the depth of tumor invasion was the risk factor of patient's prognosis on multivariate Cox regression analysis. Conclusions Operation combined with adjuvant therapy can improve the survival of the patient with stage Ⅲ melanoma in gastrointestinal tract. The depth of tumor invasion is a risk factor of survival in these patients.