Chatzistefanou Ioannis, Kolokythas Antonia, Vahtsevanos Konstantinos, Antoniades Konstantinos
Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
Department of Oral and Maxillofacial Surgery, University of Rochester, Rochester, New York, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jul;122(1):17-27. doi: 10.1016/j.oooo.2016.01.005. Epub 2016 Jan 14.
Primary mucosal melanoma of the oral cavity is a highly aggressive malignancy of melanocytic origin. The aim of this study is to report a case series of oral mucosal melanomas (OMMs) and provide a review of the literature with regard to treatment guidelines for and prognosis of this pathologic entity.
We report three cases of OMMs treated in our institutions and the results of a literature review, in which the words "oral" and "mucosal melanoma" were used as the main keywords.
Surgical resection of the primary tumor with wide resection margins appears to be the recommended primary treatment modality with the aim to achieve tumor-free margins. Elective neck dissection and adjuvant radiotherapy have been advocated for locoregional control. Chemotherapy has not been shown to improve survival and is mainly used for palliative purposes. Immunotherapy and biochemotherapy seem to significantly improve survival and could open new therapeutic horizons.
The prognosis of OMMs remains poor despite treatment. Early diagnosis and aggressive surgical resection followed by adjuvant therapies could be the key to improving survival. Multicenter randomized clinical trials, which may be difficult to conduct because of the rarity to the lesion, would aid in the development of new strategies.
口腔原发性黏膜黑色素瘤是一种起源于黑素细胞的高度侵袭性恶性肿瘤。本研究旨在报告一组口腔黏膜黑色素瘤（OMM）病例系列，并对该病理实体的治疗指南和预后进行文献综述。
我们报告了在我们机构治疗的3例OMM病例以及文献综述结果，其中以“口腔”和“黏膜黑色素瘤”作为主要关键词。
采用宽切缘对原发性肿瘤进行手术切除似乎是推荐的主要治疗方式，目的是实现无瘤切缘。选择性颈清扫术和辅助放疗已被提倡用于局部区域控制。化疗尚未显示能提高生存率，主要用于姑息治疗。免疫疗法和生物化疗似乎能显著提高生存率，并可能开辟新的治疗前景。
尽管进行了治疗，OMM的预后仍然很差。早期诊断和积极的手术切除后辅以辅助治疗可能是提高生存率的关键。由于该病变罕见，可能难以开展多中心随机临床试验，这将有助于制定新的策略。
