Опухоли головы и шеи. 2016; 6: 19-25
ОСОБЕННОСТИ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ МЕЛАНОМЫ КОЖИ ГОЛОВЫ И ШЕИ. СОВРЕМЕННЫЙ ВЗГЛЯД НА ПРОБЛЕМУ
https://doi.org/10.17650/2222-1468-2016-6-4-19-25Аннотация
Меланома кожи (МК) относится к числу высокоагрессивных злокачественных опухолей. В структуре общей онкологической заболеваемости МК составляет 1–4 %, их доля среди всех злокачественных новообразований кожи 3–5 %. По данным разных авторов, в области головы и шеи (ГШ) встречаются 22–46 % всех меланом. Несмотря на революционные открытия последних лет в области лекарственной терапии метастатической меланомы, основным методом лечения первичной МК до сих пор остается хирургический. Однако в настоящее время вопрос о ширине хирургического отступа по-прежнему оста ется открытым, особенно в области ГШ, так как необходимость экономного иссечения тканей наиболее актуальна для этой зоны. Несмотря на появление современных технологий в области диагностики метастазов в лимфатические узлы (ЛУ), остаются также нерешенными вопрос о диагностике скрытых метастазов в ЛУ и дальнейшая тактика лечения этих больных.
Целью настоящей публикации является обзор литературы о современном состоянии проблемы в области хирургического лечения МК ГШ. В данной статье выполнен анализ публикаций, посвященных хирургическому лечению, а также диагностике метастазов МК в ЛУ области ГШ.
Список литературы
1. Двойрин В.В., Церковный Г.Ф., Аксель Е.М. Заболеваемость населения СССР злокачественными новообразованиями (1985–1989 гг.). Вопросы онкологии 1991;(4):401–36. [Dvoyrin V.V., Tserkovnyy G.F., Aksel’ E.M. Morbidity of malignant neoplasms of the USSR (1985–1989). Voprosy onkologii = Oncology Issues 1991;(4):401–36. (In Russ.)].
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23. Serrone L., Solivetti F.M., Thorel M.F. et al. High frequency ultrasound in the preoperative staging of primary melanoma: a statistical analysis. Melanoma Res 2002;12(3):287–90.
24. Bessoud B., Lassau N., Koscielny S. et al. High-frequency sonography and color Doppler in the management of pigmented skin lesions. Ultrasound Med Biol 2003;29(6):875–9.
25. Voit C., Mayer T., Kron M. et al. Efficacy of ultrasound B-scan compared with physical examination in follow-up of melanoma patients. Cancer 2000;90(3):186–93.
26. Voit C.A., van Akkooi A.C.J., fer-Hesterberg G.S. et al. Rotterdam Criteria for Sentinel Node (SN) Tumor Burden and the Accuracy of Ultrasound (US) Guided Fine-Needle Aspiration Cytology (FNAC): Can US-Guided FNAC Replace SN Staging in Patients With Melanoma? J Clin Oncol2009;27(30):4994–5000.
27. Van den Brekel M.W., Pameijer F.A., Koops W. et al. Computed tomography for the detection of neck node metastases in melanoma patients. Eur J Surg Oncol 1998;24(1):51–4.
28. Halpern B.S., Schiepers C., Weber W.A. et al. Presurgical staging of non-small cell lung cancer: positron emission tomography, integrated positron emission tomography/CT, and software image fusion. Chest 2005;128(4):2289–97.
29. Klode J., Dissemond J., Grabbe S. et al. Sentinel lymph node excision and PET-CT in the initial stage of malignant melanoma: a retrospective analysis of 61 patients with malignant melanoma in American joint committee on cancer stages I and II. Dermatol Surg 2010;36(4):439–45.
30. Morton D.L., Thompson J.F., Cochran A.J. et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 2006;355(13):1307–17.
31. Chao C., Wong S.L., Edwards M.J. et al. Sentinel lymph node biopsy for head and neck melanomas. Ann Surg Oncol 2003;10(1):21–6.
32. Morton D.L., Cochran A.J., Thompson J.F. et al. Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg 2005;242(3):302–11; discussion 311–3.
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34. Balch C.M., Smalley R.V., Bartolucci A. et al. A randomized prospective clinical trial of adjuvant C. parvum immunotherapy in 260 patient with clinically localized melanoma (stage I): prognostic factors analysis and preliminary results of immunotherapy. Cancer 1982;49(6):1079–84.
35. Morton D.L., Wen D.R., Foshag L.J. et al. Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol 1993;11:1751–6.
36. O’Brien C.J., Uren R.F., Thompson J.F. et al. Prediction of potential metastatic sites in cutaneous head and neck melanoma using lymphoscintigraphy. Am J Surg 1995;170:461–6.
Head and Neck Tumors (HNT). 2016; 6: 19-25
SURGICAL TREATMENT OF HEAD AND NECK CUTANEOUS MELANOMA: A MODERN APPROACH TO THE PROBLEM
https://doi.org/10.17650/2222-1468-2016-6-4-19-25Abstract
Cutaneous melanoma (CM) is a highly aggressive malignant tumor. The incidence of CM is 1–4 % of all cancers and 3–5 % of all malignant neoplasms of the skin. According to different authors, CM is localized in the area of head and neck (H&N) in 22–46 %. Despite revolutionary discoveries in recent years in the treatment of metastatic melanoma, the main treatment option of primary СМ is still surgery. However, the question about the size of surgical margins and tissue sparing excision is still pending, particularly in the area of the head and neck. Despite the possibilities of modern methods of revealing of metastases in lymph nodes (LN), diagnosis of “latent” metastases in LN and further tactics of treatment remains the matter of argument. The purpose of this publication is to review the literature on the current problem in the surgical treatment of СМ of the H&N.
This article is the result of analysis of publication devoted to surgical treatment and diagnosis of СМ metastases in the LN of the H&N.
References
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3. Friedman R.J., Rigel D.S., Silverman M.K. et al. Malignant melanoma in the 1990s: the continued importance of early detection and the role of physician examination and self-examination of the skin. Cancer 1991;41(4):201–26.
4. Morton D.L., Essner R., Kirkwood J.M., Wollman R.C. Malignant Melanoma. London, 2000.
5. Breslow A. Thickness, cross-sectional areas and depth of invasion in prognosis of cutaneous melanoma. Ann Surg 1970;172(5):902–8.
6. AJCC (American Joint Committee on Cancer) Cancer Staging Hand-book: TNM Classification of Malignant Tumors. 6th edn. New York: Springer-Verlag, 2002.
7. Balch C.M., Gershenwald J.E., Soong S. et al. Final version of 2009 AJCC Melanoma Staging and Classification. J Clin Oncol 2009;27(36):6199–206. DOI: 10.1200/JCO.2009.23.4799.
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9. Veronesi U., Casinelli N., Adarnus J. et al. Thin stage I primary cutaneous malignant melanoma: comparison of excision with margins of 1 or 3 cm. N Engl J Med 1988;318:1159–62.
10. Essner R. Surgical treatment of malignant melanoma. Surg Clin North Am 2003;83:109–56.
11. Handley W.S. The pathology of melanotic growths in relation to their operative management. Lancet 1907;1:27.
12. Ames F.S., Balch C.M., Reintgen D. Losal reccurenses and their management. Philadelphia: JB Lippincott, 1992. 287 p.
13. Balch C.M., Hjugton A.N., Peters L.I. Cutaneous Melanoma. In: Principles and Practice of Oncology. Philadelphia, 1993. Pp. 1612–61.
14. Davis N.C. Cutaneous melanoma: The Queensland experience. Curr Probl Surg 1976;13(5):28–31.
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16. Khayat D., Rixe O., Martin G. et al. Surgical margins in cutaneous melanoma (2 cm versus 5 cm for lesions measuring less than 2.1-mm thick). Cancer 2003;97(8): 1941–6.
17. Cohn-Cedermark G., Rutqvist L.E., Andersson R. et al. Long term results of a randomized study by the Swedish Melanoma Study Group on 2-cm versus 5-cm resection margins for patients with cutaneous melanoma with a tumor thickness of 0.8–2.0 mm. Cancer 2000;89(7):1495–501.
18. Cascinelli N., Belli F., Santinami M. et al. Sentinel lymph node biopsy in cutaneous melanoma: the WHO Melanoma Program experience. Ann Surg Oncol 2000;7(6): 469–74.
19. Balch C.M., Soong S.J., Smith T. et al. Long-term results of a prospective surgical trial comparing 2 cm vs 4 cm excision margins for 740 patients with 1–4 mm melanomas. Ann Surg Oncol 2001;8(2):101–8.
20. Thomas J.M., Newton-Bishop J., Hern R. et al. Excision margins in high-risk malignant melanoma. N Engl J Med 2004;350:757–66.
21. Ringborg U., Brahme E.M., Drewiecki K. Randomized trial of a resection margin of 2 cm versus 4 cm for cutaneous malignant melanoma with a tumor thickness of more than 2 mm. World Congress on Melanoma, 6–10 September 2005. Vancouver, Canada, 2005.
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23. Serrone L., Solivetti F.M., Thorel M.F. et al. High frequency ultrasound in the preoperative staging of primary melanoma: a statistical analysis. Melanoma Res 2002;12(3):287–90.
24. Bessoud B., Lassau N., Koscielny S. et al. High-frequency sonography and color Doppler in the management of pigmented skin lesions. Ultrasound Med Biol 2003;29(6):875–9.
25. Voit C., Mayer T., Kron M. et al. Efficacy of ultrasound B-scan compared with physical examination in follow-up of melanoma patients. Cancer 2000;90(3):186–93.
26. Voit C.A., van Akkooi A.C.J., fer-Hesterberg G.S. et al. Rotterdam Criteria for Sentinel Node (SN) Tumor Burden and the Accuracy of Ultrasound (US) Guided Fine-Needle Aspiration Cytology (FNAC): Can US-Guided FNAC Replace SN Staging in Patients With Melanoma? J Clin Oncol2009;27(30):4994–5000.
27. Van den Brekel M.W., Pameijer F.A., Koops W. et al. Computed tomography for the detection of neck node metastases in melanoma patients. Eur J Surg Oncol 1998;24(1):51–4.
28. Halpern B.S., Schiepers C., Weber W.A. et al. Presurgical staging of non-small cell lung cancer: positron emission tomography, integrated positron emission tomography/CT, and software image fusion. Chest 2005;128(4):2289–97.
29. Klode J., Dissemond J., Grabbe S. et al. Sentinel lymph node excision and PET-CT in the initial stage of malignant melanoma: a retrospective analysis of 61 patients with malignant melanoma in American joint committee on cancer stages I and II. Dermatol Surg 2010;36(4):439–45.
30. Morton D.L., Thompson J.F., Cochran A.J. et al. Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 2006;355(13):1307–17.
31. Chao C., Wong S.L., Edwards M.J. et al. Sentinel lymph node biopsy for head and neck melanomas. Ann Surg Oncol 2003;10(1):21–6.
32. Morton D.L., Cochran A.J., Thompson J.F. et al. Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg 2005;242(3):302–11; discussion 311–3.
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34. Balch C.M., Smalley R.V., Bartolucci A. et al. A randomized prospective clinical trial of adjuvant C. parvum immunotherapy in 260 patient with clinically localized melanoma (stage I): prognostic factors analysis and preliminary results of immunotherapy. Cancer 1982;49(6):1079–84.
35. Morton D.L., Wen D.R., Foshag L.J. et al. Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol 1993;11:1751–6.
36. O’Brien C.J., Uren R.F., Thompson J.F. et al. Prediction of potential metastatic sites in cutaneous head and neck melanoma using lymphoscintigraphy. Am J Surg 1995;170:461–6.
