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原发性鼻黏膜黑色素瘤的临床特征与预后——附44例报告

[Clinical characteristics and prognosis of primary nasal mucosal melanoma--a report of 44 cases].

作者信息

Peng Rui-Qing, Wu Guo-Hao, Chen Wen-Kuan, Ding Ya, Ma Jin, Zhang Nian-Hua, Su Yi-Shun, Zhang Xiao-Shi

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.

出版信息

Ai Zheng. 2006 Oct;25(10):1284-6.

Abstract

BACKGROUND & OBJECTIVE: Primary mucosal malignant melanoma of the nasal cavity, paranasal sinuses, and nasopharynx is rare and current research data of this disease are mainly from western populations. This study was to analyze the clinical characteristics of this disease and prognositic factors.

METHODS

From Jan. 1971 to Jul. 2005, 66 patients with primary nasal mucosal melanoma were treated in Cancer Center of Sun Yat-sen University, China. Demographics and baseline characteristics, treatments, recurrence, metastasis, and survival were documented in hospital records. All records of these patients were analyzed retrospectively. Kaplan-Meier method was used to calculate survival rate; Cox model was used to analyze prognostic factors.

RESULTS

Among 44 evaluable cases, 37 were originated from the nasal cavity, 5 from the paranasal sinuses, and 2 from the nasopharynx. Cervical lymphadenopathy at initial presentation occurred in 12 patients. Of the 31 patients received operation-dominated treatment, 8 received adjuvant radiotherapy, 13 received adjuvant chemotherapy, and 6 received adjuvant non-specific immunotherapy. The median time of follow-up was 29 months. Local recurrence, cervical lymphadenopathy, and distant metastasis occurred in 24, 10, and 11 patients, respectively, during follow-up. The median survival time was 24 months and the 5-year survival time was 25%. Clinical stage affected prognosis, whereas age, gender, site, primary tumor mass, and adjuvant therapy were not correlated to survival status.

CONCLUSION

Nasal mucosal melanoma has high incidence of local recurrence and distant metastasis, especially cervical lymphadenopathy. Clinical stage affects the prognosis.

摘要

背景与目的

鼻腔、鼻窦及鼻咽部原发性黏膜恶性黑色素瘤较为罕见,目前关于该疾病的研究数据主要来自西方人群。本研究旨在分析该疾病的临床特征及预后因素。

方法

1971年1月至2005年7月,中国中山大学肿瘤防治中心收治了66例原发性鼻黏膜黑色素瘤患者。医院记录中记载了患者的人口统计学和基线特征、治疗情况、复发、转移及生存情况。对这些患者的所有记录进行回顾性分析。采用Kaplan-Meier法计算生存率;采用Cox模型分析预后因素。

结果

在44例可评估病例中,37例起源于鼻腔,5例起源于鼻窦,2例起源于鼻咽部。初诊时12例患者出现颈部淋巴结肿大。在31例接受以手术为主治疗的患者中,8例接受辅助放疗,13例接受辅助化疗,6例接受辅助非特异性免疫治疗。中位随访时间为29个月。随访期间分别有24例、10例和11例患者出现局部复发、颈部淋巴结肿大和远处转移。中位生存时间为24个月,5年生存率为25%。临床分期影响预后,而年龄、性别、部位、原发肿瘤大小及辅助治疗与生存状况无关。

结论

鼻黏膜黑色素瘤局部复发和远处转移发生率高,尤其是颈部淋巴结肿大。临床分期影响预后。

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