Surgical Treatment For Cutaneous Malignant Melanoma

Objective: To investigate the efficacy of plastic surgical treatment for cutaneous malignant melanoma.Methods: From January 2007 to March 2015, retrospective analysis of clinical records, surgical procedures and the prognosis was performed in 20 patients who were diagnosed of cutaneous malignant melanoma and underwent plastic surgical treatment. According to American Joint Committee on Cancer(AJCC) staging system(seventh edition), two patient was in stage Ⅰ, two patients were in stage ⅡA, one patient was in stage ⅡB, three patients were in stage ⅡC, three patients were in stage ⅢA, three patients were in stage ⅢB, five patients were in stage ⅢC, and one patient was in stage Ⅳ. The surgical procedures include extensive skin resection for 6 patients, extensive skin resection plus construction with skin graft or local flap for 5 patients, finger(toe) amputation for 2 patients, and extensive skin resection plus one-stage ilioinguinal lymph node dissection for 5 patients, and extensive skin resection plus one-stage axillary lymph node dissection for 2 patients. Twelve patients received interferon or interleukin treatment. Fifteen patients were followed-up, with an average follow-up period of 15 months(range: 2-46months).Results: All of two stage Ⅰ patients survived; of 4 stage Ⅱ patients, 2 patients had linguinal lymph node, 15 months after surgical treatment;of 8 stage Ⅲ patients, 3 patients died of lung metastasis;of 1 stage Ⅳ patient died of liver metastasis 12 months after surgical treatment. Of the 15 patients who were followed-up, 9 patients survived with neither local recurrence nor progressive disease. Lymph node dissection for 7 patients, of the 5 patients who were followed-up, one died,4 patients survived.Conclusions: Early diagnosis and surgical treatment of cutaneous malignant melanoma can achieve satisfying disease control, and the standardized sentinel lymph node biopsy and regional lymph node dissection is important in the control of tumor progression, as well as the adjuvant therapy is benefit for the survival. Sentinel lymph node biopsy has a very important function in the accurate staging, diagnosis,and treatment of malignant melanoma. Postoperative adjuvant therapy can improve the quality of survival.