Tamura Keiichi, Kumabe Yohei, Kishimoto Yo, Kitamura Morimasa, Mizuta Masanobu, Tamaki Hisanobu, Honda Keigo, Yamada Koichiro, Tanaka Shinzo, Kojima Tsuyoshi, Asato Ryo, Ushiro Koji, Shinohara Shogo, Takebayashi Shinji, Maetani Toshiki, Ichimaru Kazuyuki, Kitani Yoshiharu, Omori Koichi
Department of Otolaryngology-Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Otolaryngology-Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
Acta Otolaryngol. 2024 Jan;144(1):82-89. doi: 10.1080/00016489.2024.2314590. Epub 2024 Feb 16.
Mucosal melanoma of the head and neck (MMHN) is a rare condition. This study aimed to investigate oncological outcomes of surgical intervention in patients with MMHN.
The study included 34 patients with MMHN who underwent surgical resection as initial treatment at 10 institutions in Japan between July 2005 and June 2015. Results: The 5-year overall survival (OS), local control rate (LCR), disease-free survival (DFS), and disease-specific survival (DSS) rates were 48.7%, 53.4%, 32.4%, and 55.1%, respectively. Based on multivariate analysis, no independent prognostic factors for the 5-year OS and DSS were found. Based on univariate analysis, the 5-year LCR was worse in patients with lesions in the nasal cavity and paranasal sinuses than in the oral cavity and pharynx. However, no differences in oncological outcomes were identified in relation to primary sites, and postoperative radiotherapy (PORT) and adjuvant systemic therapy did not contribute to improvements in the 5-year OS.
No independent prognostic factors for the 5-year OS or DSS were identified. Regional or distant recurrences are often identified, regardless of local control with surgical resection. Difficult control of MMHN with conventional therapeutic strategies, such as surgical intervention, PORT, and systemic therapy, has been suggested.
头颈部黏膜黑色素瘤(MMHN)是一种罕见疾病。本研究旨在调查MMHN患者手术干预的肿瘤学结局。
本研究纳入了2005年7月至2015年6月期间在日本10家机构接受手术切除作为初始治疗的34例MMHN患者。结果:5年总生存率(OS)、局部控制率(LCR)、无病生存率(DFS)和疾病特异性生存率(DSS)分别为48.7%、53.4%、32.4%和55.1%。基于多变量分析,未发现5年OS和DSS的独立预后因素。基于单变量分析,鼻腔和鼻窦病变患者的5年LCR比口腔和咽部病变患者更差。然而,未发现肿瘤学结局在原发部位方面存在差异,术后放疗(PORT)和辅助全身治疗对5年OS的改善没有贡献。
未发现5年OS或DSS的独立预后因素。无论手术切除的局部控制情况如何,区域或远处复发经常被发现。提示采用手术干预、PORT和全身治疗等传统治疗策略难以控制MMHN。