Lai Yuting, Meng Xinjun, Liu Quan, Lu Hanyu, Guo Limin, Wang Shuyi, Wang Dehui
Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, China.
Department of Otolaryngology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Acta Otolaryngol. 2020 Jan;140(1):79-84. doi: 10.1080/00016489.2019.1635269. Epub 2019 Nov 22.
The optimal treatment modality for sinonasal mucosal melanoma (SNMM) remains controversial. To investigate the impact of adjuvant therapy on SNMM. Ninety-two patients were retrospectively analyzed and were grouped into surgery alone (SA), surgery plus radiotherapy (SR), surgery plus chemotherapy (SC) and surgery plus radiochemotherapy (SRC) groups. Survival outcomes among different treatment modalities were analyzed using the Kaplan-Meier method and log-rank test. Twenty-nine patients (31.5%) developed local recurrence, 10 patients (10.9%) had nodal metastasis, and 41 patients (44.6%) had distant metastasis. The overall survival time (OS) for SA, SR and SRC were 16, 29 and 27 months, respectively, and the disease-free survival time (DFS) were 10, 16 and 16 months, respectively. Significant differences were found between SA and SR (OS: = .003; DFS: = .016) and SA and SRC (OS: = .002; DFS: = .008). Superior outcomes were also found in SRC group compared to that in SA group for both OS (15 vs. 27 months, = .012) and DFS (10 vs. 20 months, = .017) in endoscopic approach. SNMM had poor prognosis with high rates of local recurrence and metastasis. Adjuvant therapy improved survival outcomes for SNMM.
鼻窦黏膜黑色素瘤（SNMM）的最佳治疗方式仍存在争议。为研究辅助治疗对SNMM的影响。对92例患者进行回顾性分析，并分为单纯手术（SA）、手术加放疗（SR）、手术加化疗（SC）和手术加放化疗（SRC）组。采用Kaplan-Meier法和对数秩检验分析不同治疗方式的生存结果。29例患者（31.5%）发生局部复发，10例患者（10.9%）出现淋巴结转移，41例患者（44.6%）发生远处转移。SA、SR和SRC组的总生存时间（OS）分别为16、29和27个月，无病生存时间（DFS）分别为10、16和16个月。SA与SR之间（OS：=0.003；DFS：=0.016）以及SA与SRC之间（OS：=0.002；DFS：=0.008）存在显著差异。在内镜治疗中，SRC组在OS（15个月对27个月，=0.012）和DFS（10个月对20个月，=0.017）方面也优于SA组。SNMM预后较差，局部复发和转移率较高。辅助治疗改善了SNMM的生存结果。
