Department of Medicine, Division of Digestive Diseases, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
Department of Internal Medicine, The Wright Center for Graduate Medical Education, 501 S. Washington Avenue, Scranton, PA, 18505, USA.
BMC Gastroenterol. 2022 Apr 9;22(1):178. doi: 10.1186/s12876-022-02254-5.
Gastrointestinal malignant melanoma is a rare mucosal melanoma (MM). Other MM include the respiratory and the genitourinary tract. All mucosal melanomas have a poor prognosis when compared to cutaneous melanomas. Ano-rectal melanomas are by far the most common and most studied gastrointestinal MM. Large-scale clinical data is lacking due to the rarity of the disease. We aim to analyze epidemiology and survival of the Gastrointestinal (G.I.) MM over 45 years using a national database.
The Surveillance, Epidemiology and End Results (SEER) database was queried to identify patients with biopsy-proven G.I. Melanomas. We selected tumor site, intervention, and survival information for oncology codes as per the international classification of diseases. Survival analysis was performed using the SPSS v 27 ® IBM software.
Of the 1105 biopsy-proven confirmed cases of primary G.I. melanoma's, 191 (17.3%) received chemotherapy (C.T.), 202 (18.3%) received radiotherapy (R.T.), 63 (5.7%) received both C.T and R.T., while 684 (61.9%) of the population received surgery alone or combined with C.T. and/or R.T. Statistically significant improvement in survival was noted in all treatment strategies that utilized surgery and also when site-specific MM cohorts underwent a surgical approach with or without C.T and/or R.T.
This is the most extensive study reporting epidemiological and survival data of treatment strategy outcomes of primary G.I. mucosal melanoma elucidating best overall survival with a management strategy involving surgical intervention.
胃肠道恶性黑色素瘤是一种罕见的黏膜黑色素瘤（MM）。其他 MM 包括呼吸道和泌尿生殖道。与皮肤黑色素瘤相比，所有黏膜黑色素瘤的预后都较差。肛门直肠黑色素瘤是迄今为止最常见和研究最多的胃肠道 MM。由于疾病罕见，缺乏大规模的临床数据。我们旨在使用国家数据库分析超过 45 年的胃肠道（GI）MM 的流行病学和生存率。
通过监测、流行病学和最终结果（SEER）数据库，确定经活检证实的胃肠道黑色素瘤患者。我们根据国际疾病分类选择肿瘤部位、干预和生存信息进行肿瘤学编码。使用 SPSS v 27 ® IBM 软件进行生存分析。
在 1105 例经活检证实的原发性胃肠道黑色素瘤患者中，191 例（17.3%）接受化疗（C.T.），202 例（18.3%）接受放疗（R.T.），63 例（5.7%）接受 C.T.和 R.T.联合治疗，而 684 例（61.9%）患者仅接受手术或联合 C.T.和/或 R.T.治疗。在所有采用手术的治疗策略以及在特定部位的 MM 队列中进行手术联合或不联合 C.T.和/或 R.T.的治疗策略中，均观察到生存的统计学显著改善。
这是一项最广泛的研究，报告了原发性胃肠道黏膜黑色素瘤的流行病学和治疗策略结果的生存数据，阐明了涉及手术干预的最佳总体生存率的管理策略。
