Liu Zhi-Ping, Luo Jing-Wei, Xu Guo-Zhen, Gao Li, Yi Jun-Lin, Huang Xiao-Dong, Qu Yuan, Wang Kai, Zhang Shi-Ping, Xiao Jian-Ping
a Department of Radiation Oncology , National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Chaoyang District , Beijing , China.
b Department of Oncology , The First Affiliated Hospital of Harbin Medical University , Nangang District , Harbin , Heilongjiang Province , China.
Acta Otolaryngol. 2017 Oct;137(10):1115-1120. doi: 10.1080/00016489.2017.1336797. Epub 2017 Jun 22.
To analyse the failure patterns and prognostic factors influencing survival in patients with primary mucosal melanoma of the nasal cavity and paranasal sinuses.
Fifty-one patients were analysed retrospectively. Forty-eight, 33, 10, and 13 patients underwent surgery, radiotherapy, chemotherapy, and immunotherapy, respectively. Failure events, including local recurrence, regional relapse, distant metastases, and death, were examined.
During follow-up (median: 59.0 months), 36 patients experienced failure after treatment, including local (n = 17), regional (n = 8), and distant organ (n = 23) metastases. The median failure times for local, regional, and distant metastases were 13.0, 14.0, and 8.0 months, respectively. The median survival times from local, regional, and distant failure to death were 10.5, 8.0, and 4.0 months, respectively. The 5-year overall survival rates of patients with and without distant organ metastases were 14.4% and 72.6%, respectively (p < .001). Multivariate analyses showed that radiotherapy increased local recurrence-free and regional relapse-free survival. Patients with stage IV tumours had reduced distant metastasis-free and overall survival compared to patients with stage I-III tumours.
Distant metastasis was mainly owing to failure. Radiotherapy and the disease stage were prognostic factors for survival.
分析鼻腔和鼻窦原发性黏膜黑色素瘤患者的失败模式及影响生存的预后因素。
对51例患者进行回顾性分析。分别有48例、33例、10例和13例患者接受了手术、放疗、化疗和免疫治疗。对包括局部复发、区域复发、远处转移和死亡在内的失败事件进行了检查。
在随访期间（中位时间：59.0个月），36例患者在治疗后出现失败，包括局部转移（n = 17）、区域转移（n = 8）和远处器官转移（n = 23）。局部、区域和远处转移的中位失败时间分别为13.0个月、14.0个月和8.0个月。从局部、区域和远处失败到死亡的中位生存时间分别为10.5个月、8.0个月和4.0个月。有远处器官转移和无远处器官转移患者的5年总生存率分别为14.4%和72.6%（p < 0.001）。多因素分析显示，放疗可提高局部无复发生存率和区域无复发生存率。与I-III期肿瘤患者相比，IV期肿瘤患者的无远处转移生存率和总生存率降低。
远处转移主要归因于治疗失败。放疗和疾病分期是生存的预后因素。
