Huang Shiang-Fu, Liao Chun-Ta, Kan Chun-Ran, Chen I-How
Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Tao-Yuan, Taiwan.
J Otolaryngol. 2007 Apr;36(2):124-9. doi: 10.2310/7070.2007.0010.
Melanomas that arise in the nasal cavity or paranasal sinuses are rare and have a poor prognosis. In this study, we reviewed 15 patients in a tertiary referral centre and analyzed their treatment results and patterns of treatment failure.
Fifteen patients diagnosed from January 1994 to February 2005 at the Chang Gung Memorial Hospital were retrospectively reviewed.
Eight men (53.3%) and seven (46.7%) women ranged in age from 51 to 85 years (mean 69.0 years) at the time of diagnosis. All patients presented with symptoms related to the nose. The majority of patients presented with epistaxis (93.3%). Ten patients received surgery and postoperative radiotherapy, three patients received surgery and postoperative chemo- and radiotherapy, and one patient received radiotherapy alone. The overall actuarial survival revealed that 49.5% were alive at 2 years and 33.0% were alive at 5 years. The average time from surgery to local recurrence was 5 months, the average time from surgery to the occurrence of regional recurrence was 7.45 months, and the time from surgery to the diagnosis of distant metastasis was 10.3 months. The sites of distant metastasis according to frequency are the lung, liver, bone, and brain. The average survival after the diagnosis of distant metastasis was 8 months.
The prognosis of mucosal melanoma of the nasal cavity is poor in our experience. Most of the local recurrence, regional recurrence, and distant metastasis occurs in the first year after surgery. For those patients in the first year after surgery, frequent and regular follow-up is mandatory.
鼻腔或鼻窦发生的黑色素瘤较为罕见，预后较差。在本研究中，我们回顾了一家三级转诊中心的15例患者，并分析了他们的治疗结果及治疗失败模式。
回顾性分析了1994年1月至2005年2月在长庚纪念医院确诊的15例患者。
8名男性（53.3%）和7名女性（46.7%），诊断时年龄在51至85岁之间（平均69.0岁）。所有患者均有与鼻部相关的症状。大多数患者表现为鼻出血（93.3%）。10例患者接受了手术及术后放疗，3例患者接受了手术及术后化疗和放疗，1例患者仅接受了放疗。总体精算生存率显示，2年生存率为49.5%，5年生存率为33.0%。从手术到局部复发的平均时间为5个月，从手术到区域复发的平均时间为7.45个月，从手术到远处转移诊断的时间为10.3个月。远处转移部位按发生频率依次为肺、肝、骨和脑。远处转移诊断后的平均生存时间为8个月。
根据我们的经验，鼻腔黏膜黑色素瘤预后较差。大多数局部复发、区域复发和远处转移发生在术后第一年。对于术后第一年的患者，必须进行频繁且定期的随访。
