Rojas-Lechuga María Jesús, Jubés Sara, Molina-García Manuel, da Silva-Júnior Rui Milton Patricio, Sampieri Claudio, Langdon Cristóbal, Gras-Cabrerizo Juan Ramón, Bernal-Sprekelsen Manuel, Puig Susana, Alobid Isam
Otorhinolaryngology Department, Hospital Clinic of Barcelona, Universitat de Barcelona (UB), 08036 Barcelona, Spain.
Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, Universitat de Barcelona (UB), 08036 Barcelona, Spain.
J Pers Med. 2024 Nov 26;14(12):1120. doi: 10.3390/jpm14121120.
: Sinonasal mucosal melanomas (SNMMs) are rare and aggressive malignancies with poor survival outcomes. Our systematic review and meta-analysis aim to evaluate overall survival (OS) rates in patients with SNMM; : We conducted a systematic search, following PRISMA guidelines across PubMed, Web of Science (WOS), and citation searching for studies reporting survival and prognosis outcomes for SNMMs. Inclusion criteria included studies with 5-year OS rates. Studies were excluded if they included tumor sites other than the paranasal sinuses or nasal cavity, were published in languages other than English and Spanish, or had a sample size of fewer than 15 patients. Two reviewers independently screened studies, extracted data, and assessed study quality using the Joanna Briggs Institute (JBI) critical appraisal checklist. Analyses of survival probabilities were conducted. Meta-analyses were performed using a random-effects model. PROSPERO ID CRD42024565137; : A total of 515 articles were identified after removing duplicates, and 99 reports were assessed for eligibility. Of these, 35 studies were included in the meta-analysis, encompassing a total of 2383 SNMM patients, of whom 1192 (50%) were female, with a weighted mean age of 65.4 years (SD = 5.4). Fifteen studies were from Europe (42.9%), six (17.1%) were from America, eleven (31.4%) were from Asia, two (5.7%) were from Australia, and one (2.9%) combined European, United Kingdom, and American populations. The 5-year OS was 34.8 [95% CI = 30.6-39.5], with the highest OS in America at 40.5 [95% CI = 34.1-48.1], followed by Europe at 36.6 [95% CI = 30.6-43.7], Australia at 32.3 [95% CI = 12.5-83.8], and Asia at 28.1 [95% CI = 19.5-40.7]. The age-standardized incidence rate (ASIR) for SNMM ranges was between 0.07 and 0.14 per 100,000 persons/year, with a slightly higher incidence in women than in men; : This meta-analysis, one of the largest to date on SNMM, confirms the aggressive nature of this melanoma subtype with poor survival outcomes. Despite geographic differences in survival rates, the overall 5-year survival remains low, highlighting the urgent need for improved treatment strategies and more research to improve patient outcomes.
鼻窦黏膜黑色素瘤（SNMM）是罕见且侵袭性强的恶性肿瘤，生存预后较差。我们的系统评价和荟萃分析旨在评估SNMM患者的总生存率（OS）；我们按照PRISMA指南在PubMed、科学网（WOS）上进行了系统检索，并通过引文检索纳入报告SNMM生存和预后结果的研究。纳入标准包括报告5年总生存率的研究。若研究纳入的肿瘤部位不是鼻窦或鼻腔，以英语和西班牙语以外的语言发表，或样本量少于15例患者，则予以排除。两名研究者独立筛选研究、提取数据，并使用乔安娜·布里格斯研究所（JBI）的关键评价清单评估研究质量。进行了生存概率分析。使用随机效应模型进行荟萃分析。国际前瞻性系统评价注册库（PROSPERO）编号：CRD42024565137；去除重复项后共识别出515篇文章，对99篇报告进行了资格评估。其中，35项研究纳入荟萃分析，共涉及2383例SNMM患者，其中1192例（50%）为女性，加权平均年龄为65.4岁（标准差=5.4）。15项研究来自欧洲（42.9%），6项（17.1%）来自美洲，11项（31.4%）来自亚洲，2项（5.7%）来自澳大利亚，1项（2.9%）纳入了欧洲、英国和美洲人群。5年总生存率为34.8[95%置信区间（CI）=30.6 - 39.5]，美洲的总生存率最高，为40.5[95%CI = 34.1 - 48.1]，其次是欧洲，为36.6[95%CI = 30.6 - 43.7]，澳大利亚为32.3[95%CI = 12.5 - 83.8]，亚洲为28.1[95%CI = 19.5 - 40.7]。SNMM的年龄标准化发病率（ASIR）范围为每10万人年0.07至0.14，女性发病率略高于男性；这项荟萃分析是迄今为止关于SNMM规模最大的分析之一，证实了这种黑色素瘤亚型的侵袭性本质及其较差的生存预后。尽管生存率存在地域差异，但总体5年生存率仍然较低，凸显了迫切需要改进治疗策略并开展更多研究以改善患者预后。
