Kingdom T T, Kaplan M J
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco 94143-0342, USA.
Head Neck. 1995 May-Jun;17(3):184-9. doi: 10.1002/hed.2880170303.
Mucosal melanomas of the nasal cavity and paranasal sinuses are rare and do poorly.
Seventeen patients treated from 1981 to 1993 at a single referral center were retrospectively reviewed.
Thirteen patients underwent surgical resection, with seven receiving postoperative radiotherapy. Eight had microscopically negative margins. The actuarial 2-year and 5-year survivals for this group of 13 were 67% (8 of 12) and 20% (2 of 10). The local recurrence rate was 85% (11 of 13) and distant metastases occurred in 31% (4 of 13) patients. In the absence of metastatic disease, resection of recurrent tumor correlated with disease-free intervals ranging from 3 months to 40 months.
Those who received postoperative radiotherapy appeared to have done better with increased disease-free intervals and prolonged survival. Negative surgical margins were not predictive of a more favorable outcome. Surgical resection followed by postoperative radiotherapy is appropriate and resection of recurrent tumor should be considered.
鼻腔和鼻窦黏膜黑色素瘤罕见且预后较差。
回顾性分析了1981年至1993年在单一转诊中心接受治疗的17例患者。
13例患者接受了手术切除，其中7例接受了术后放疗。8例切缘显微镜下阴性。这13例患者的2年和5年精算生存率分别为67%（12例中的8例）和20%（10例中的2例）。局部复发率为85%（13例中的11例），31%（13例中的4例）患者发生远处转移。在无转移性疾病的情况下，复发性肿瘤的切除与3个月至40个月的无病间期相关。
接受术后放疗的患者似乎预后较好，无病间期延长，生存期延长。手术切缘阴性并不能预测更好的预后。手术切除后进行术后放疗是合适的，应考虑切除复发性肿瘤。
