朱鸿 1董丹丹 1李芳华 1刘丹丹 1王雷 1傅静 1宋林红 1徐钢1
作者信息
摘要
Abstract
Purpose To study clinicopathologic features and prognostic differences of noncutaneous malignant melanoma ( nonCMM ) originated from different anatomic sites.Methods Clinicopathologic and survival data were analyzed in 65 cases of nonCMM.Results Of the 65 nonCMM patients, 35 ( 53.8% ) were males and 30 ( 46.2% ) females with mean age of 63.4 years ( s = 10.347 ).54 patients had mucosal malignant melanoma ( MMM ) and 11 patients had ocular malignant melanoma ( OMM ).For MMM, sinonasal area was the most common anatomic site ( n = 29, 44.6% ), followed by oral cavity ( n =8, 12.3% ), genitourinary tract ( n = 8, 12.3% ), anorectum ( n = 7 , 10.8% ), esophagus ( n = 2, 3.1% ).For OMM , uveal melanoma ( n = 7 , 10.8% ) was the most common site, followed by bulbar conjunctiva ( n = 4 , 6.2% ).With the median follow up for 27 months ( range: 3 ~ 60 months ), the median overall survival time was 36 months ( 95% CI: 34.874 ~37.126 ) for all patients.Kaplan-Meier survival analysis suggested that the patients with OMM had distinctly longer survival time than patients with MMM ( x2 =12.735 , P <0.001 ) and without recurrence after surgery.Patients with anorectal melanoma had shorter survival time than patients with sinonasal, oral cavity and genitourinary tract melannoma without recurrence postoperation, which x2 values were 18.735 , 3.867 and 5.134, respectively, and the P values were < 0.001 , 0.049 and 0.023 respectively, whereas there were no significantly differences among patients with sinonasal, oral cavity and genitourinary tract melanoma.Univariate analysis suggested the age ( x2 = 16.889, P < 0.001 ) and tumor size ( x2 = 4.381 , P = 0.036 ) were related to the prognosis.Cox regression multivariate analysis showed the age ( x2 = 4.447, P - 0.035 , RR = 1.068 , 95% 67 = 1.005 ~ 1.136 ) and tumor size ( x2 = 5.957 , P = 0.015 , RR = 1.479 , 95% CI = 1.080 ~ 2.026 ) were main prognostic risk factors for postoperative survival.Conclusion There is different prognosis in patients with different primary anatomic sites of nonCMM.Survival outcome of patients with OMM is much better than those with MMM.For MMM, patients with anorectal melanoma have the worse survival outcome.Elderly and larger tumor size are the main factors affecting prognosis.关键词
黑色素瘤/非皮肤恶性黑色素瘤/黏膜恶性黑色素瘤/眼球恶性黑色素瘤/预后Key words
melanoma/noncutaneous maligant melanoma/mucosal malignant melannoma/ocular malignant melanoma/prognosis分类
医药卫生
