Janardhan Deepak, George Nebu Abraham, Suresh Sandeep, Patil Shirish, Thomas Shaji, Iype Elizabeth Mathew
Department of Head and Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, Kerala India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2099-2103. doi: 10.1007/s12070-020-01962-2. Epub 2020 Aug 6.
Mucosal melanoma of oral cavity (MMO) is a relatively rare tumour comprising of 40% of all head and neck mucosal melanomas. This study assessed the treatment outcomes and factors affecting prognosis in oral cavity mucosal melanomas. The clinical case records of 25 cases of oral cavity mucosal melanomas treated in our institution during 2003-2013 were retrospectively reviewed. Various clinicopathological parameters were taken into consideration and statistical analysis done by Kaplan-Meier method and Cox's proportional hazards model. The most common sites of MMO were upper alveolus and hard palate (64%) followed by lower alveolus (28%). 57.1% mucosal melanomas of hard palate and upper alveolus had associated metastatic lymph nodes whereas all cases of MMO of lower alveolus had lymph node metastasis. Disease failure at distant sites was higher than that at primary site or lymph nodes. The most common site of distant metastases was brain. The 5-year OS for treated cases was 23.8% and among subsites, MMO of hard palate and upper alveolus had the highest survival. Metastasis to lymph nodes and bone infiltration by tumour significantly decreased the survival. Recurrence at primary site had the worst prognosis. MMO with lymph nodal involvement and bone erosion had poor prognosis. Due to high chances of lymph node metastases and disease recurrence in lymph nodes following treatment, it is essential to do an elective neck dissection for all cases of MMO. Disease failure at primary site was an independent predictor of outcome in MMO.
口腔黏膜黑色素瘤（MMO）是一种相对罕见的肿瘤，占所有头颈部黏膜黑色素瘤的40%。本研究评估了口腔黏膜黑色素瘤的治疗结果及影响预后的因素。回顾性分析了2003年至2013年在本机构接受治疗的25例口腔黏膜黑色素瘤的临床病例记录。考虑了各种临床病理参数，并采用Kaplan-Meier法和Cox比例风险模型进行统计分析。MMO最常见的部位是上牙槽和硬腭（64%），其次是下牙槽（28%）。硬腭和上牙槽的黏膜黑色素瘤中有57.1%伴有转移性淋巴结，而下牙槽的所有MMO病例均有淋巴结转移。远处部位的疾病失败率高于原发部位或淋巴结。远处转移最常见的部位是脑。治疗病例的5年总生存率为23.8%，在各亚部位中，硬腭和上牙槽的MMO生存率最高。肿瘤转移至淋巴结和骨浸润显著降低了生存率。原发部位复发的预后最差。伴有淋巴结受累和骨侵蚀的MMO预后较差。由于治疗后淋巴结转移和疾病复发的可能性较高，因此对所有MMO病例进行选择性颈清扫至关重要。原发部位的疾病失败是MMO预后的独立预测因素。
