鼻窦黏膜黑色素瘤：58例患者的12年经验。

Sinonasal mucosal melanoma: A 12-year experience of 58 cases.

作者信息

Lombardi Davide, Bottazzoli Marco, Turri-Zanoni Mario, Raffetti Elena, Villaret Andrea Bolzoni, Morassi Maria Laura, Ungari Marco, Vermi William, Battaglia Paolo, Castelnuovo Paolo, Facco Carla, Sessa Fausto, Donato Francesco, Nicolai Piero

机构信息

Department of Otorhinolaryngology, University of Brescia, Brescia, Italy.

Department of Otorhinolaryngology, University of Insubria, Varese, Italy.

出版信息

Head Neck. 2016 Apr;38 Suppl 1:E1737-45. doi: 10.1002/hed.24309. Epub 2015 Dec 17.

DOI:10.1002/hed.24309

PMID:26676523

Abstract

BACKGROUND

Sinonasal mucosal melanoma is a rare malignancy with poor prognosis.

METHODS

Patients with sinonasal malignant melanoma who underwent surgery by different approaches were included in this study. Overall survival (OS) and event-free survival were calculated, and statistically significant variables by univariate analysis were entered in a multivariate Cox regression model.

RESULTS

Pathological staging was pT3, pT4a, and pT4b in 30 cases (51.7%), 17 cases (29.3%), and 11 cases (19.0%). At 3 and 5 years, OS was 43.5% and 29% and event-free survival was 23.6% and 12.4%, respectively. At univariate analysis, OS was significantly influenced by male sex, advanced pT classification, positive margins, and surgical approach; event-free survival was affected by positive margins. At multivariate analysis, the risk of death was independently associated with male sex (hazard ratio [HR] = 2.27; p = .04) and positive margins (HR = 2.32; p = .03).

CONCLUSION

Male sex and positive margins were negative prognostic factors. Endoscopic resection did not show an increased risk of death compared with more extensive surgical approaches. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1737-E1745, 2016.

摘要

背景

鼻窦黏膜黑色素瘤是一种罕见的恶性肿瘤，预后较差。

方法

本研究纳入了通过不同手术方式治疗的鼻窦恶性黑色素瘤患者。计算总生存期（OS）和无事件生存期，并将单因素分析中有统计学意义的变量纳入多因素Cox回归模型。

结果

病理分期为pT3、pT4a和pT4b的患者分别有30例（51.7%）、17例（29.3%）和11例（19.0%）。3年和5年时，总生存期分别为43.5%和29%，无事件生存期分别为23.6%和12.4%。单因素分析显示，总生存期受男性性别、pT分期进展、切缘阳性和手术方式的显著影响；无事件生存期受切缘阳性的影响。多因素分析显示，死亡风险独立与男性性别（风险比[HR]=2.27；p=0.04）和切缘阳性（HR=2.32；p=0.03）相关。