Folz B J, Niemann A M, Lippert B M, Hauschild A, Werner J A
Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie der Universität Kiel.
Laryngorhinootologie. 1997 May;76(5):289-94. doi: 10.1055/s-2007-997429.
Malignant mucosal melanoma of the upper aerodigestive tract is a rare disease. The prognosis is expected to be significantly worse than the prognosis of cutaneous melanoma and so far no uniform therapeutic concept exists. Publications about mucosal melanoma are scarce and reported patient groups are usually small.
Thirty-four patients have been registered at the ENT Department of the University of Kiel Medical Center with the diagnosis mentioned above. Clinical data were obtained from the patient's charts, the minimum follow-up was three years.
Most common site of the tumor was the nasal cavity and paranasal sinuses with 28 of 34 patients. Less frequently affected was the nasopharynx (three cases), oropharynx, larynx, and middle ear (one case each). All patients were caucasians and most of them were of an advanced age (66.9 years +/- 12.3). Treatment of choice was surgical resection in 27 cases, in four cases it was combined with radiation therapy, in one case with radiation therapy and chemotherapy, and in three cases with chemotherapy. Six patients received solely radiation therapy, one patient was only treated by chemotherapy. Patients who were treated by a combined approach had a more favourable outcome than patients who were treated by a monotherapy of surgery, radiation therapy, or chemotherapy. A high number of recurrences were observed, which occurred on an average of 16.6 months after the diagnosis of the primary tumor. Overall 5-year survival was 45.8%, the 10-year survival rate was 22.3%.
Optimized combined therapeutical approaches might possibly improve the prognosis of mucosal melanoma of the upper aerodigestive tract. Intervals between follow-ups should be short to render detection of relapses at an early stage. Repeated therapy of recurrent disease might lengthen survival.
上呼吸道消化道恶性黏膜黑色素瘤是一种罕见疾病。其预后预计比皮肤黑色素瘤差得多，且目前尚无统一的治疗方案。关于黏膜黑色素瘤的出版物稀少，所报道的患者群体通常规模较小。
基尔大学医学中心耳鼻喉科已登记34例诊断为上述疾病的患者。临床数据取自患者病历，最短随访时间为3年。
肿瘤最常见的部位是鼻腔和鼻窦，34例患者中有28例。较少受累的是鼻咽（3例）、口咽、喉和中耳（各1例）。所有患者均为白种人，且大多数年龄较大（66.9岁±12.3岁）。27例患者的首选治疗方法是手术切除，4例患者手术联合放疗，1例患者手术联合放疗及化疗，3例患者仅接受化疗。6例患者仅接受放疗，1例患者仅接受化疗。采用联合治疗方法的患者比接受手术、放疗或化疗单一疗法的患者预后更好。观察到大量复发情况，平均在原发性肿瘤诊断后16.6个月出现。总体5年生存率为45.8%，10年生存率为22.3%。
优化的联合治疗方法可能会改善上呼吸道消化道黏膜黑色素瘤的预后。随访间隔应缩短，以便早期发现复发。对复发性疾病进行重复治疗可能会延长生存期。
