Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Laryngoscope. 2020 Mar;130(3):622-627. doi: 10.1002/lary.28065. Epub 2019 May 11.
OBJECTIVES/HYPOTHESIS: Sinonasal mucosal melanoma (SNMM) is a rare malignant neoplasm. No study to date has analyzed the impact that nodal metastases and distant metastases at diagnosis have on overall survival (OS) and disease-specific survival (DSS).
Retrospective database review.
The Surveillance, Epidemiology, and End Results database was queried for cases of SNMM. Descriptive statistics were used analyze patient demographic and clinicopathologic variables. The Kaplan-Meier model was used to analyze survival, and the Cox proportional hazards model was used for multivariate analysis.
Three hundred twenty-eight cases of SNMM were identified. The most frequent sinonasal anatomic location was the nasal cavity in 279 (73.0%) patients, followed by the maxillary sinus in 60 (15.7%) patients. Regional nodal metastases at diagnosis occurred in 33 (8.6%) patients, whereas distant metastases at diagnosis occurred in 41 (10.7%) patients. Five-year OS was 22.7%, and 5-year DSS was 26.8%. The presence of positive nodes at diagnosis (OS P < .0001, DSS P < .0001), distant metastases at diagnosis (OS P = .0442, DSS P = .0442), primary tumor site (OS P < .0001, DSS P < .0001), and increasing age (OS P = .0012, DSS P = .0016) were found to be significant as negative predictors of OS and DSS.
SNMM is a rare pathologic entity with a poor prognosis. The presence of nodal and distant metastases at diagnosis are negative prognostic factors in OS and DSS. These factors can be used in the development of new models of risk stratification and to inform treatment strategies and surveillance patterns.
NA Laryngoscope, 130:622-627, 2020.
目的/假设：鼻腔鼻窦黑色素瘤（SNMM）是一种罕见的恶性肿瘤。迄今为止，尚无研究分析诊断时的淋巴结转移和远处转移对总生存（OS）和疾病特异性生存（DSS）的影响。
回顾性数据库研究。
对 SNMM 病例进行监测、流行病学和最终结果数据库查询。使用描述性统计分析患者的人口统计学和临床病理变量。Kaplan-Meier 模型用于分析生存情况，Cox 比例风险模型用于多变量分析。
共确定了 328 例 SNMM 患者。最常见的鼻腔鼻窦解剖部位是鼻腔 279 例（73.0%），其次是上颌窦 60 例（15.7%）。诊断时发生区域淋巴结转移 33 例（8.6%），诊断时发生远处转移 41 例（10.7%）。5 年 OS 为 22.7%，5 年 DSS 为 26.8%。诊断时存在阳性淋巴结（OS P <.0001，DSS P <.0001）、诊断时远处转移（OS P =.0442，DSS P =.0442）、原发肿瘤部位（OS P <.0001，DSS P <.0001）和年龄增加（OS P =.0012，DSS P =.0016）是 OS 和 DSS 的阴性预测因子。
SNMM 是一种罕见的病理实体，预后不良。诊断时存在淋巴结和远处转移是 OS 和 DSS 的阴性预后因素。这些因素可用于开发新的风险分层模型，并为治疗策略和监测模式提供信息。
NA Laryngoscope，130：622-627，2020。
