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头颈部黏膜黑色素瘤:一项回顾性研究及当前观点

Mucosal Melanoma of the Head and Neck: A Retrospective Review and Current Opinion.

作者信息

Pincet Laurence, Lambercy Karma, Pasche Philippe, Broome Martin, Latifyan Sofiya, Reinhard Antoine

机构信息

ENT Department, CHUV, Lausanne, Switzerland.

Maxillofacial Department, CHUV, Lausanne, Switzerland.

出版信息

Front Surg. 2021 Jan 20;7:616174. doi: 10.3389/fsurg.2020.616174. eCollection 2020.

Abstract

Head and Neck Mucosal Melanoma (HNMM) is an uncommon malignancy that arises in decreasing order in the nasal cavity, the paranasal sinuses, and the oral cavity. Although radical surgery followed by eventual radiotherapy is acknowledged as the mainstay treatment, patients with advanced stages or multi-focal tumors benefit from new systemic therapies. We wish to share our experience with these treatments and review the current literature. We present a case review of every patient treated in our center for an HNMM over the past 10 years, including every patient treated in our center for an HNMM over the past 10 years. We analyzed clinical characteristics, treatment modalities, and outcomes. We included eight patients aged from 62 to 85 years old. We found six MM in the nasal cavity, one in the sphenoidal sinus, and one in the piriform sinus. Six patients underwent endoscopic surgery with negative margins, six underwent radiotherapy with variable modalities. Immunotherapy or targeted therapy was given in cases extensive tumors without the possibility of a surgical treatment or in two patient as an adjuvant treatment after R0 surgery. The three-year overall survival was 50%, and three patients (37.5%) are in remission. HNMM is associated with poor oncologic outcomes regarding the concerned patients of our review, as reported in the literature. New treatments such as immunotherapies or targeted therapies have not significantly changed the prognosis, but they may offer new interesting perspectives. Our small series of cases seems to confirm that surgical resection with negative margins improves overall survival.

摘要

头颈部黏膜黑色素瘤(HNMM)是一种罕见的恶性肿瘤,其发病部位以鼻腔、鼻窦和口腔的顺序递减。尽管根治性手术加最终放疗被公认为主要治疗方法,但晚期或多灶性肿瘤患者可从新的全身治疗中获益。我们希望分享我们在这些治疗方面的经验并回顾当前的文献。我们对过去10年在我们中心接受HNMM治疗的每一位患者进行了病例回顾,包括过去10年在我们中心接受HNMM治疗的每一位患者。我们分析了临床特征、治疗方式和结果。我们纳入了8名年龄在62岁至85岁之间的患者。我们发现6例黑色素瘤位于鼻腔,1例位于蝶窦,1例位于梨状窦。6例患者接受了切缘阴性的内镜手术,6例接受了不同方式的放疗。对于无法进行手术治疗的广泛肿瘤患者或2例患者在R0手术后作为辅助治疗给予免疫治疗或靶向治疗。三年总生存率为50%,3例患者(37.5%)处于缓解期。正如文献报道的那样,就我们所回顾的相关患者而言,HNMM的肿瘤学预后较差。免疫治疗或靶向治疗等新治疗方法并未显著改变预后,但它们可能提供新的有趣前景。我们的小系列病例似乎证实切缘阴性的手术切除可提高总生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2cd/7873938/aa41360e1776/fsurg-07-616174-g0001.jpg

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