Ercelep Ozlem, Topcu Turkan Ozturk, Bayoglu Ibrahim Vedat, Ekinci Ahmet Siyar, Koca Sinan, Kavgaci Halil, Ozcelik Melike, Alacacioglu Ahmet, Uzunoglu Sernaz, Bozkurt Oktay, Ulas Arife, Aksoy Asude, Taskoylu Burcu Yapar, Gumussay Ozge, Yaman Sebnem, Uysal Mukremin, Aydin Dincer, Gumus Mahmut
Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey.
Department of Medical Oncology, Pendik Education and Research Hospital, Marmara University, Istanbul, Turkey.
Tumour Biol. 2016 Sep;37(9):12033-12038. doi: 10.1007/s13277-016-5076-0. Epub 2016 May 12.
Mucosal melanoma (MM) is a rare type of cancer that differs significantly from cutaneous melanoma. In this study, we aimed to evaluate clinical and demographical characteristics, prognoses and factors influencing survival, treatment alternatives, and features of different subtypes of the patients. The patients were followed up with and treated in different centers due to their diagnoses of MM. We retrospectively analyzed data of 107 patients who were diagnosed with MM in 14 different institutions in Turkey. The mean age of the patients was 64.5 years. Of the patients, 47 % were female and 53 % were male. The median overall survival (OS) was 17 months, and the mean follow-up duration was 27 months. The 2-year survival rate was 42 %, and the 5-year survival rate was 23 %. The best survival rate appeared in those patients with MM in the head-neck region (median survival rate was 27 months, P = 0.034). The most common anatomical site was the head-neck region. In a univariate analysis, variables including age ≥65 years, the anatomical site of the primary lesion other than head and neck region, the metastatic stage of the disease, high levels of lactate dehydrogenase (LDH), and an Eastern Cooperative Oncology Group Performance Status (ECOG PS) of ≥1 were found to be associated with poor survival (P < 0.05). However, in a multivariate analysis, only advanced stage disease (HR = 2.70; 95 % CI, 1.64-4.45; P = 0.000) and high LDH levels (HR = 2.31; 95 % CI, 1.40-3.80; P = 0.001) were determined to be adverse prognostic variables. Primary MM presents a more aggressive behavior and offers a poorer prognosis compared to cutaneous melanoma. Because the disease is rarely seen, is heterogeneous, and lacks randomized studies, issues concerning optimal treatment approaches and management and clinical characteristics of the disease have not been clarified yet.
黏膜黑色素瘤（MM）是一种罕见的癌症类型，与皮肤黑色素瘤有显著差异。在本研究中，我们旨在评估患者的临床和人口统计学特征、预后及影响生存的因素、治疗选择以及不同亚型的特征。由于被诊断为MM，这些患者在不同中心接受随访和治疗。我们回顾性分析了在土耳其14个不同机构被诊断为MM的107例患者的数据。患者的平均年龄为64.5岁。其中，47%为女性，53%为男性。中位总生存期（OS）为17个月，平均随访时间为27个月。2年生存率为42%，5年生存率为23%。头颈部MM患者的生存率最佳（中位生存率为27个月，P = 0.034）。最常见的解剖部位是头颈部区域。在单因素分析中，发现年龄≥65岁、除头颈部区域外的原发性病变解剖部位、疾病的转移阶段、高乳酸脱氢酶（LDH）水平以及东部肿瘤协作组体能状态（ECOG PS）≥1等变量与不良生存相关（P < 0.05）。然而，在多因素分析中，仅晚期疾病（HR = 2.70；95%CI，1.64 - 4.45；P = 0.000）和高LDH水平（HR = 2.31；95%CI，1.40 - 3.80；P = 0.001）被确定为不良预后变量。与皮肤黑色素瘤相比，原发性MM表现出更具侵袭性的行为且预后更差。由于该疾病罕见、具有异质性且缺乏随机研究，关于最佳治疗方法、管理以及该疾病的临床特征等问题尚未明确。
