Malignant Melanoma of the Skin: Report of 341 Cases Treated during the Years 1929-1943

This paper will summarize the results of treatment obtained at the Radiumhemmet in cooperation with several Swedish surgical departments in patients with cutaneous malignant melanoma, admitted during a 15-year period from 1929 through 1943.Our results are gained by means of conservative surgery in combination with irradiation.This analysis was performed with a view to elucidating factors of importance and possible deficiencies in present principles of treatment in order to improve future methods.For this reason, data regarding the indications for palliative treatment by surgery and radiation as well as records of many peculiar cases have been omitted.Detailed clinical reviews by MIESCHER (45), MOIR et al. (47), PACK & LIVINGSTON, and others (1, 3, 4, 9, 34) cover all pertinent aspects.The report was limited to melanomas of the skin in order to avoid cases with regional gland stations inaccessible to clinical classification.The tables are for comparison kept close to those published by PACK, PERZIK & SCHARNAGEL (54), who reviewed 862 cases seen at the Memorial Hospital from 1917 to 1946.For previous reports from Radiumhemmet the readers are referred to a paper by SCHAR-NAGEL (61) on cutaneous melanomas treated between 1921 and 1930, and further the epibulbar melanomas have been dealt with by LARSSON (39).Considering pathological and biological aspects, the heterogeneity of this group of tumours is regarded as an established fact (5,16,52).Present insufficiencies in histological diagnosis and classification also influence the clinical management of melanomas to a certain degree.All the same, the factors for proper treatment are defined by the pronounced tendency to early and wide-spread dissemination and by the high degree of radio-Submitted for publication, April 20, 1949.