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Comparison of two methods of treating primary malignant melanomas clark IV and V, thickness 1.5 mm and greater, localized on the extremities. Wide surgical excision with and without adjuvant regional perfusion
Author(s) -
Md Hendrik Martijn,
Koops Heimen Schraffordt,
Milton Gerald W.,
Nap Marius,
Wolter J. Oosterhuis,
Shaw Helen M.,
Oldhoff Jan
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19860515)57:10<1923::aid-cncr2820571006>3.0.co;2-e
Subject(s) - medicine , melanoma , perfusion , surgery , survival rate , dissection (medical) , lymph node , wide local excision , adjuvant , stage (stratigraphy) , primary tumor , infiltration (hvac) , adjuvant therapy , cancer , radiology , chemotherapy , metastasis , paleontology , physics , cancer research , biology , thermodynamics
A comparative retrospective study of patients with primary malignant melanomas of the extremities, Clark level IV/V and tumor thickness ≤ 1.5 mm, was performed in Sydney (Australia) and Groningen (The Netherlands). The efficacy of wide local excision combined with adjuvant regional perfusion (Groningen) was compared with that of wide surgical excision only (Sydney). Patients were classified by sex and tumor location. There were only sufficient numbers of female patients with a tumor of the lower extremity available for this comparative study. All patients were stage I and none received prophylactic lymph node dissection. Age, tumor location, tumor thickness, depth of infiltration and ulceration were taken into account and the factors studied within this group were 10‐year disease‐free rate, 10‐year survival rate, and local and regional recurrences. Women with a melanoma of the leg (excluding the foot) who had been treated by excision and adjuvant regional perfusion, had a significantly better 10‐year disease‐free rate ( P <0.0005), a significantly higher 10‐year survival rate (0.010 < P <0.025) and significantly fewer local/regional recurrences ( P <0.0005) than women treated by wide local excision only. For tumors of the foot, however, no significant differences in 10‐year disease‐free rate, 10‐year survival rate or local/regional recurrences were observed after perfusion.