Snow G B, van der Esch E P, van Slooten E A
Head Neck Surg. 1978 Sep-Oct;1(1):24-30. doi: 10.1002/hed.2890010104.
Mucosal melanoma of the head and neck is a rare condition. This study presents a review of 26 patients with such tumors, followed up at a minimum of 5 years. The 5-year survival rate in this group was 38%. Recurrences with a fatal outcome, however, have been encountered up to 12 years after initial diagnosis. Primary radical surgery offers the best chance for local control. Nasal-cavity lesions seem to be associated with a better prognosis than oral-cavity tumors. Analysis of pathologic features by microstage measurement showed that the majority of tumors were of considerable thickness. This factor may partially explain the poor prognosis associated with mucosal melanomas in comparison to their cutaneous counterparts. Local recurrences and distant metastases were the principal causes of treatment failure. A persistent treatment policy, however, may still substantially prolong survival in such cases. Regional lymph-node metastasis did not pose a significant problem in the management of these tumors. Recognition of the nature and significance of the appearance of oral melanosis is stressed.
头颈部黏膜黑色素瘤是一种罕见疾病。本研究对26例此类肿瘤患者进行了回顾性分析，随访时间至少为5年。该组患者的5年生存率为38%。然而，在初次诊断后长达12年仍有出现致命复发的情况。原发性根治性手术为局部控制提供了最佳机会。鼻腔病变的预后似乎比口腔肿瘤更好。通过微分期测量对病理特征进行分析显示，大多数肿瘤厚度可观。与皮肤黑色素瘤相比，这一因素可能部分解释了黏膜黑色素瘤预后较差的原因。局部复发和远处转移是治疗失败的主要原因。然而，持续的治疗策略在这类病例中仍可能显著延长生存期。区域淋巴结转移在这些肿瘤的治疗中并非重大问题。强调了对口腔黑变病表现的性质和意义的认识。
