ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A review of the hereditary aspects of the malignant melanomas showed causal heterogeneity and similar pathogenesis based on the dysregulation of the paracrine/autocrine growth mechanisms. The genetically different malignant melanomas have a range of recurrence risks from 1% for the nonfamilial, solitary, malignant melanoma to a risk exceeding 70% for the syndromic melanomas of neurocutaneous melanosis and the nine types of xeroderma pigmentosum. A recurrence risk of 6% is relevant to the members of dysplastic nevus syndrome families without malignant melanomas and the risk increases in excess of 50% for the individuals of families with dysplastic nevi and more than one malignant melanoma.

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Early recognition of melanoma is directly related to improvement in survival. Patients, therefore, must not only be educated in recognition of abnormal skin lesions, but also in proper skin examination, ultraviolet radiation protection, effect of drugs on the development of malignancies, and dietary means of promoting wellness and preventing disease. Basic patient instruction should begin at the time of diagnosis and should include all health care team members to assure patient comprehension and compliance with recommendations.

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Seventy-five patients with melanoma were surveyed for recent history of major stress, coping styles, and psychiatric disturbance. Recurrence of disease was strongly related to biological variables (stage and Breslow depths) but not to psychological measures. Major life stress was not related to stage, Breslow, Clark level, or estimates of lymphocytic infiltration of tumor. Coping styles were paradoxically related to major life stress such that history of major stresses was associated with greater confrontation of the melanoma diagnosis, greater will to fight the disease, and less avoidance of its frightening aspects. Experience with fewer major life stresses was associated with a defeatist attitude characterized by an expectation of a poor prognosis and little control over outcomes. More than 50% of the sample had experienced at least one major life stress in the past 5 years. This figure is consistent with prior work and indicative of a higher than normal rate of major life stress in the years before diagnosis.

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Surgical excisional therapy of malignant melanoma is the primary method of treatment for malignant melanoma. The exact size of the excisional therapy depends on the depth and location of the tumor. At the University of South Florida (Tampa, FL), tumors less than 0.76 mm in depth are resected with a 1-cm margin and tumors greater than 0.76 mm in depth are resected with a 3-cm margin. The location of the tumor also determines the exact margin of excision. Maximal reconstructive efforts following general principles of plastic and reconstructive surgery are noted and used for producing an optimal functional and aesthetic result.

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

All patients with stage I and stage II malignant melanoma of the skin were analyzed for stage; time of local, regional, or systemic recurrence, or two or more of these events; presence or absence of ulceration of the primary tumor; thickness of the primary tumor; level of invasion according to Clark; and margins of resection. Local recurrence had a significant negative impact on the long-term survival of patients. Our data revealed that local recurrence had the same poor prognostic effect as regional or systemic recurrence, or both. Factors significant in predicting local recurrence included the primary tumor characteristics of ulceration of the primary tumor and thickness of the primary tumor. Margins of resection and level of invasion were not noted significant in predicting local recurrence.

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The development and rationale for the use of lymphoscintigraphy in the preoperative evaluation of patients with malignant melanoma being considered for elective lymph node dissection is reviewed. This overview is updated by an analysis of 135 patients with early stage malignant melanoma involving the head, neck, shoulders, and trunk at Moffitt Cancer Center and Research Institute at the University of South Florida (Tampa, FL). High discordancy rates (overall, 41%) were seen between drainage patterns predicted from historical anatomical guidelines and those revealed by the lymphoscintigraphic examination. The high discordancy rate was most pronounced in the head (64%) and the neck (73%). Surgical management was changed in 33% of the patients, overall. A preoperative lymphoscintigram is recommended for all patients with melanoma with head, neck, and truncal lesions evaluated for elective lymph node dissection as the lymphatic drainage patterns are often unpredictable and variable.

ISSN:0148-7043    

出版商:OVID    

年代:1992

数据来源: OVID