Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical developments in 23 patients with stage I melanoma of the lower limbs were followed over a 2 year period. The subjects were divided into two groups based on lymphographic findings (14 negative, 9 positive or dubious). All underwent excision of the primary tumor, but none underwent prophylactic lymphadenectomy. At the end of the 2 year period there were no significant differences in the clinical developments in the two groups.
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PMID:Comparison between lymphographic findings and clinical follow-up in malignant melanoma. 55 98

The clinical course of 66 patients with stage I melanoma, diagnosed during pregnancy, treated in the Division of Surgical Oncology at UCLA, was retrospectively reviewed. These patients were compared with 619 nonpregnant female patients with melanoma. There was no significant difference between the pregnant population and control population with respect to location of the primary tumor, age at diagnosis, Clark's level, mean depth of invasion (pregnant females, 1.24 mm vs control, 1.28 mm), and histologic type. The 5-year survival for the women diagnosed with melanoma during pregnancy and for the entire population was 86% and 87%, respectively. These results demonstrate that women diagnosed with melanoma during pregnancy fare no worse than their nonpregnant counterparts. Criteria other than the theoretical effect of pregnancy on the tumor should be used to counsel patients diagnosed with melanoma during pregnancy.
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PMID:Prognostic significance of pregnancy in stage I melanoma. 280 88

Among proponents of elective lymph node dissection (ELND) for clinical stage I melanoma, controversy exists as to whether there is an upper limit of tumor thickness beyond which ELND should not be considered. We reviewed 169 patients with clinical stage I and II melanoma that was greater than or equal to 3.0 mm thick and who were treated at the University of Illinois Hospital, Chicago. Of 139 patients with clinical stage I disease, 117 underwent ELND. Five- and ten-year survival rates were 55.7% and 48.9%, respectively. Multifactorial analysis demonstrated that anatomical location, level, pathologic stage, and ulceration were the best predictors of survival. Thickness did not emerge as a significant variable. Our findings do not support basing treatment decisions, eg, ELND in this group of patients, solely on the thickness of the primary tumor. We continue to recommend ELND in patients with either intermediate or thick melanomas.
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PMID:Cutaneous thick melanoma. Prognosis and treatment. 357 86

The level of invasion of the primary tumor is a reliable criterion of prognosis for cutaneous melanoma. Hence it follows that a differential surgical treatment is possible especially in the clinical stage I. Primary treatment of malignant melanoma consists of three-dimensional excision. The width of excision is determinated by the microstage. The elective regional lymphadenectomy shows an apparant benefit for stage I melanoma with a level between 1.5 and 4.0 mm. The value of added treatments (radiotherapy, systemic, and local chemotherapy, immuntherapy) is still controversial, but should be considered in the future clinical and therapeutical research.
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PMID:[Surgical treatment of malignant melanoma of the skin with special reference to the vertical tumor diameter]. 648 96

1164 patients with stage I melanoma of the skin who were submitted to wide excision only of the primary tumor were studied to evaluate the rates of regional lymph node and distant metastases. Of these, 516 (44.3%) had a recurrence of the disease which was at regional lymph nodes in 264 (22.7%), at distant sites in 91 (7.8%), and simultaneously at regional lymph nodes and distant sites in 161 (13.8%). Most of the patients had a relapse within 5 years: regional node metastases were most frequently observed during the first 3 years, and distant metastases appeared later. The ratio regional:distant metastases was not different (P greater than 0.05) when subgroups of patients were considered according to prognostic criteria (sex, site of origin, levels, thickness, ulceration). Sex, levels, thickness and ulceration were found to be significantly related with the frequency of recurrences (regional and distant). It is concluded that the prognostic criteria considered do not predict whether the tumor will metastasize to regional nodes or to distant sites.
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PMID:Metastatic spread of stage I melanoma of the skin. 664 71

Thirteen variables were studied to determine their usefulness in predicting recurrent disease in 158 patients with stage I melanoma of the lower extremity. A Cox proportional hazards analysis demonstrated that three variables were independent risk factors for recurrent disease in these patients: (1) thickness, in millimeters, of the primary tumor (P = 0.000009), (2) primary tumor location on the foot (P = 0.0003), and (3) the number of mitoses/mm2 (P = 0.0244). Life-table analyses of patient subgroups defined by different combinations of these three variables demonstrated that thick (greater than or equal to 3.0 mm) melanomas of the foot were associated with recurrent disease much more frequently than tumors of similar thickness located on the thigh or calf. These data provide guidelines that can be used to evaluate results of surgical and/or adjuvant therapy studies for patients with melanoma of the lower extremity.
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PMID:A prognostic model for clinical stage I melanoma of the lower extremity. Location on foot as independent risk factor for recurrent disease. 722 89

Fifteen variables were studied for their usefulness in predicting recurrent disease in 254 patients with clinical stage I melanoma of the trunk. Thickness of the primary tumor correctly predicted outcome with an accuracy of 90 percent or greater in 176 patients with melanoma primaries with a thickness of less than 1.70 mm or 5.5 mm or greater. No other variables significantly increased predictive accuracy over these ranges of thickness. A Cox proportional hazards analysis of the remaining 78 patients with primary tumors 1.70 to 5.49 mm thick demonstrated that the following four variables functioned as independent risk factors for recurrent disease: (1) thickness of the primary tumor (p = 0.0005), (2) mitoses/mm2 greater than 6 (p = 0.006), (3) a nearly absent or minimal lymphocyte response at the base of the tumor (p = 0.009), and (4) location on the upper trunk (p = 0.03). Trunk lesions located near the midline did not have a worse prognosis than more lateral melanomas of similar thickness.
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PMID:A prognostic model for clinical stage I melanoma of the trunk. Location near the midline is not an independent risk factor for recurrent disease. 725 36

There is no doubt about the fact that surgery is mandatory for primary melanoma. The problem in the recent past has been how wide and deep the excision of primary melanoma has to be. Results published from the World Health Organization (WHO) Melanoma Program have clearly demonstrated that a procedure involving up to 2-mm thickness and 1-cm margins is safe. Further trials dealing with melanoma thicker than 2 mm are being carried out, and preliminary results confirm that even in this case narrow excision is the correct procedure. At present we may assume that for stage I melanoma the excision of the primary tumor should in the majority of cases allow primary closure of the wound.
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PMID:Excision of primary melanoma should allow primary closure of the wound. 759