摘要
目的:探讨头颈部黏膜黑色素瘤(head and neck mucosal melanoma,HNMM)的临床特征及预后影响因素。方法:回顾性分析2014~2023年四川省肿瘤医院收治的HNMM患者的临床资料,观察其临床特征及预后影响因素。生存分析采用Kaplan-Meier法,单因素分析采用Log-rank检验,多因素分析采用Cox比例风险模型。结果:共44例患者符合纳入排除标准,患者中位年龄60岁,男:女=1.1:1。肿瘤原发部位包括鼻腔鼻窦(n=36,81.8%)、口腔(n=5,11.4%)和其他(n=3,6.8%)。中位随访时间10个月,中位总生存期(overall survival,OS)11.58个月,1年、3年和5年的累积OS率分别为44.6%、22.0%和12.2%。初诊年龄、发病部位、AJCC分期、手术方式、是否2次手术、是否放疗、是否化疗、是否靶向治疗、初诊是否有远处转移、术后淋巴结转移的OS比较差异均无统计学意义(均P>0.05),免疫治疗(HR=0.320,95%CI:0.1~1.0,P=0.020)是HNMM患者预后的影响因素。结论:HNMM恶性程度高,预后差,在手术基础上联合免疫治疗可能会提高生存率。
Objective:To investigate the clinical features and prognostic factors of head and neck mucosal melanoma(HNMM).Methods:A retrospective analysis was performed on the clinical data of 44 patients with HNMM admitted to and treated at Sichuan Cancer Hospital between 2014 and 2023,to evaluate their clinical characteristics and prognostic factors.Survival curves were generated with the Kaplan-Meier method;univariate analysis was conducted by the Log-rank test,and multivariable analysis was performed using the Cox proportional hazards regression model.Results:A total of 44 patients met the inclusion criteria.The median age of the cohort was 60 years,with a male-to-female ratio of 1.1∶1.The primary tumor sites included the nasal cavity and paranasal sinuses(n=36,81.8%),oral cavity(n=5,11.4%),and other locations(n=3,6.8%).With a median follow-up of 10 months,the median overall survival(OS)was 11.58 months.The 1-,3-,and 5-year cumulative OS rates were 44.6%,22.0%,and 12.2%,respectively.No significant differences in OS were observed based on age at diagnosis,primary tumor site,AJCC stage,surgical approach,need for reoperation,radiotherapy,chemotherapy,targeted therapy,presence of distant metastasis at diagnosis,or postoperative lymph node metastasis(all P>0.05).Immunotherapy was a factor affecting prognosis of HNMM patients(HR=0.320,95%CI:0.10~1.00;P=0.020).Conclusion:HNMM is an aggressive malignancy with a dismal prognosis.However,surgical resection combined with immunotherapy may improve survival outcomes.
作者
王春语
毛萌洁
葛俊
鲁迎春
柳斌
Wang Chunyu;Mao Mengjie;Ge Jun;Lu Yingchun;Liu Bin(School of Medical and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,Sichuan,China;School of Medicine,University of Electronic Science and Technology of China,Chengdu 611731,Sichuan,China;Department of Medical Oncology,Sichuan Clinical Research Center for Cancer,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)
出处
《肿瘤预防与治疗》
2025年第8期680-687,共8页
Journal of Cancer Control And Treatment
基金
吴阶平医学基金(编号:320.6750)。
关键词
头颈部肿瘤
黏膜黑色素瘤
预后
生存分析
Head and neck tumor
Mucosal melanoma
Prognosis
Survival analysis
