Loree T R, Mullins A P, Spellman J, North J H, Hicks W L
Department of Head and Neck Surgery and Oncology, Roswell Park Cancer Institute, Buffalo, N.Y. 14263, USA.
Ear Nose Throat J. 1999 May;78(5):372-5.
Because mucosal melanoma of the head or neck is uncommon, retrospective data are of value in defining its natural history, response to treatment, and patterns of recurrence. We analyzed the medical records of 28 patients who had been treated for a mucosal melanoma of the head or neck between 1961 and 1993. We found that their cumulative 5-year survival rate was 20%. Patients who had primary tumors of the nasal cavity had significantly better 5-year survival than other patients. Early stage at presentation was another predictor of a more favorable outcome. Only 2 of the 17 patients (12%) who underwent surgery died with local disease. However, 13 of these 17 surgical patients (76%) eventually died of distant metastases. There were 3 long-term (> 5 yr) survivors: 2 who were treated by surgery alone, and 1 who was treated with surgery and radiation therapy. We found that aggressive resection of the primary tumor and of any local recurrence can achieve local control in most patients with mucosal melanoma of the head or neck. Distant metastasis is the limiting factor for long-term survival.
由于头颈部黏膜黑色素瘤并不常见，回顾性数据对于明确其自然病程、治疗反应及复发模式具有重要价值。我们分析了1961年至1993年间接受过头颈部黏膜黑色素瘤治疗的28例患者的病历。我们发现他们的5年累积生存率为20%。鼻腔原发性肿瘤患者的5年生存率显著高于其他患者。就诊时处于早期是预后较好的另一个预测因素。17例接受手术的患者中只有2例（12%）死于局部疾病。然而，这17例手术患者中有13例（76%）最终死于远处转移。有3例长期（>5年）存活者：2例仅接受手术治疗，1例接受手术及放射治疗。我们发现，积极切除原发性肿瘤及任何局部复发病灶可使大多数头颈部黏膜黑色素瘤患者实现局部控制。远处转移是长期生存的限制因素。
