Clinical study of forty-nine patients with malignant melanoma

Lehman, James A.; Cross, Frederick S.; Richey, Dewayne G.

doi:10.1002/1097-0142(196605)19:5<611::aid-cncr2820190503>3.0.co;2-m

Cited by 26 publications

(5 citation statements)

References 27 publications

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“…For the closure of large skin defects, we frequently applied the bilobed rotation pedicle flap, mostly on the trunk 13 . Contrary to other examiners’reports, 14,15 we did not observe any local recurrences within 3.5 years because of the primary closure. This method proved to be especially superior to skin graft, if the melanoma was located on the back.…”

Section: Commentscontrasting

confidence: 99%

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Malignant Melanoma and Lymph Nodes

Tritsch

1985

The Journal of Dermatologic Surgery and Oncology

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A total of 226 cases of malignant melanoma of the skin (MM), clinical stage I disease, located on the leg (87), arm (36), or trunk (103), were treated with elective regional node dissection (ERND). The axillary lymph nodes were dissected by a T-shaped skin incision line, whereas the inguinal nodes were removed with the help of a spindle-shaped skin excision. Both techniques, without mortality, offered the precondition for extirpation of the lymph nodes en bloc and guaranteed well-healing wounds.

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Section: Commentscontrasting

confidence: 99%

“…In addition, it reduces the size of the wound. With the final transposition of the relatively small lobes, large defects of up to a diameter of 15 cm can be closed without the use of additional skin grafts.…”

Section: Local Proceduresmentioning

confidence: 99%

Malignant Melanoma and Lymph Nodes

Tritsch

1985

The Journal of Dermatologic Surgery and Oncology

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“…24 The influence of the sex of the patient has been previously reported, women having a better prognosis than men. [25][26][27][28][29][30][31][32][33][34][35] Although multivariate analysis, in some studies, failed to demonstrate prognostic significance for sex,*' or its effect was thought to be mediated through anatomic location: the bulk of the literature has consistently pointed out the prognostic significance of sex regarding survival. Our current study supports this view and suggests that survival of men and women should be considered separately.…”

Section: Discussionmentioning

confidence: 99%

Tumor thickness and prognosis in clinical stage I malignant melanoma

Karakousis¹,

Emrich²,

Rao³

1989

Cancer

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The current grouping of patients with malignant melanoma into thin, intermediate, and thick melanomas provides a convenient but arbitrary classification which, although providing "average" survival values for each group, offers crude prognostication for the individual patient. A review of 371 patients with clinical Stage I malignant melanoma, treated during the period 1970 to 1985, was conducted. The estimated 5-year survival rate for female patients with melanomas 1.0 mm thick was 94%; for each 1-mm increment in thickness the survival rate declined by about 3%, up to the 6 mm mark, the survival rate declining thereafter by about 8% for each additional millimeter in the range of 7 to 15 mm of thickness. The estimated 5-year survival rate for male patients with melanomas 1.0 mm thick was 80%; for each 1-mm increment the survival rate declined by about 970, up to the 10 mm mark. The proposed method of estimating the expected survival according to the patient's sex and the thickness of the primary lesion hopefully provides a more accurate and convenient method of prognostication for the clinician dealing with specific patients with intermediate or thick melanomas. Cancer 64:1432-1436, 1989. HE MICROSTAGING METHODS developed by Clark et T al. I and Breslow' have led to major progress in our understanding and prognostication of malignant mela-noma. Both methods are associated with survival time and are used simultaneously in the evaluation of a primary mel-anoma. However, the two methods do not correspond exactly; occasionally Clark's level 111 or IV melanomas are less than 1 .O mm in thickne~s.~ Various studies indicate that thickness provides a more accurate prognostication which cannot be improved further with the additional information provided by Clark's m e t h ~ d. ~-~ In a previous review of patients from Roswell Park Memorial Institute (Buffalo, NY) with clinical Stage I mel-anoma, it was found that thickness was the most important prognostic indicator for survival time, followed in significance by the sex of the patient. Other factors such as location of the lesion, type of surgery, age, lymphocytic infiltration, number of mitoses, vascular invasion, and presence or absence of ulceration were not significant as prognostic indicators when a stepwise proportional haz

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“…Although Elias and others 5 reported the same survival rates for patients treated with excisions large enough to require skin grafting as for those treated with excisions small enough to permit primary closure, they found more local recurrences in the primary‐closure group. Lehman and coworkers, 6 in contrast, showed that excisions large enough to require skin grafts reduced both the melanoma mortality rate and the number of local recurrences. These studies comparing skin grafting versus primary closure are difficult to interpret because the width of the margins of excision was not reported.…”

Section: Skin Grafting Versus Primary Closurementioning

confidence: 99%