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头颈部黏膜黑色素瘤的治疗结果:来自单一机构的190例病例分析。

Treatment outcomes of mucosal melanoma of the head and neck: Analysis of 190 cases from a single institution.

作者信息

Chen Shu-Wei, Li Meng-Hua, Liu Jian-Liang, Chen Jing-Tao, Wang Jia, Li Hui, Li Xi-Yuan, Zhang Ying, Song Ming, Lu Jia-Xuan, Chen Wen-Kuan

机构信息

Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China Collaborative Innovation Center of Cancer Medicine Guangzhou Guangdong China.

Department of Pediatric Dentistry, Guanghua School of Stomatology, Affiliated Stomatological Hospital Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University Guangzhou Guangdong China.

出版信息

Laryngoscope Investig Otolaryngol. 2023 May 27;8(3):686-692. doi: 10.1002/lio2.1072. eCollection 2023 Jun.

Abstract

OBJECTIVES

To analyze the treatment outcomes and prognostic factors of mucosal melanoma of the head and neck (MMHN) from a single institution.

METHODS

From December 1989 to November 2018, 190 patients diagnosed with MMHN were included. Survival analysis was performed using the Kaplan-Meier method for univariate analysis with a log-rank test for significance and Cox regression for multivariate analysis.

RESULTS

With a median follow-up time of 43.5 months, 126 (68.5%) patients died. The median DSS was 35 months. The 3- and 5-year disease-specific survival (DSS) rates were 48.1% and 33.7%, respectively. The median overall survival (OS) was 34 months. The 3- and 5-year OS rates were 47.0% and 32.9%, respectively. In univariate analysis, the T3 stage, received surgery, R0 resection, and combined therapy (surgery+biotherapy/biochemotherapy) were significantly associated with better survival. Multivariable Cox regression analysis revealed that the T4 stage (HR = 1.692; 95% CI, 1.175-2.438;  = .005) and the N1 stage (HR = 1.600; 95% CI, 1.023-2.504;  = .039) were strong prognostic factors for poor survival, and that combined therapy (surgery+biotherapy/biochemotherapy) was a strong prognostic factor for better survival outcome (HR = 0.563; 95% CI, 0.354-0.896;  = .015).

CONCLUSION

The prognosis of MMHN remains poor. Systemic treatment is warranted to reduce MMHN progression. Surgery combined with biotherapy may improve survival.

摘要

目的

分析来自单一机构的头颈部黏膜黑色素瘤(MMHN)的治疗结果及预后因素。

方法

纳入1989年12月至2018年11月期间确诊为MMHN的190例患者。采用Kaplan-Meier法进行生存分析,单因素分析采用对数秩检验以检验显著性,多因素分析采用Cox回归。

结果

中位随访时间为43.5个月,126例(68.5%)患者死亡。中位疾病特异性生存期(DSS)为35个月。3年和5年疾病特异性生存率(DSS)分别为48.1%和33.7%。中位总生存期(OS)为34个月。3年和5年OS率分别为47.0%和32.9%。单因素分析中,T3期、接受手术、R0切除和联合治疗(手术+生物治疗/生物化疗)与更好的生存显著相关。多变量Cox回归分析显示,T4期(HR = 1.692;95%CI,1.175 - 2.438;P = 0.005)和N1期(HR = 1.600;95%CI,1.023 - 2.504;P = 0.039)是生存不良的强预后因素,联合治疗(手术+生物治疗/生物化疗)是生存结果更好的强预后因素(HR = 0.563;95%CI,0.354 - 0.896;P = 0.015)。

结论

MMHN的预后仍然很差。有必要进行全身治疗以减少MMHN进展。手术联合生物治疗可能改善生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc14/10278118/6dcdbb12072b/LIO2-8-686-g001.jpg

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