[Comparative analysis of narcosis and local anesthesia in surgery of malignant melanoma of the skin].
A nonrandomized trial was performed to compare the survival rate attained in patients with malignant melanoma who underwent their operations under general anaesthesia (g.a.) and in those who underwent surgery with only local anaesthesia (l.a.). All stage I patients were treated and followed up in our hospital exclusively. Data recorded in 190 patients operated on under g.a. from 1972 to 1980 and 376 patients operated on with l.a. from 1981 to 1987 were evaluated by computer. The 5-year survival rates calculated by the Kaplan-Meier method were as follows: Breslow's thickness up to 1.50 mm (pT1 and pT2): g.a. 91.4% l.a. 94.5%; 1.51-3.00 mm (pT3a) g.a. 64.1%, l.a. 84.5% (P less than 0.01); over 3.00 mm (pT3b and pT4) g.a. 57.9%, l.a. 62.2% (P greater than 0.05). Women with pT3a melanoma had more benefit from the operation in l.a. (93.1% to 69.7%) than did men (71.6% to 55.2%). The l.a. does not prejudice the prognosis, whether the l.a. improves the prognosis has to be stated. The available evidence that anaesthetic agents influence host defence could be an explanation for the better results with l.a.
Seebacher
C
C
Hautklinik, Bezirkskrankenhauses Dresden-Friedrichstadt.
Heubaum
F
F
Küster
P
P
Steinert
W
W
Koch
R
R
D000768:Anesthesia, General; D000772:Anesthesia, Local; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality*; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*
Vergleichende Analyse in Narkose und Lokalanästhesie operierter maligner Melanome der Haut.