Defining the role of surgery for primary gastrointestinal tract melanoma
Defining the role of surgery for primary gastrointestinal tract melanoma
复制标题
DOI：
10.1007/s11605-007-0417-3
复制
发表时间：
2008-04-01
影响因子：
3.2
通讯作者：
Koniaris, Leonidas G.
中科院分区：
文献类型：
--
作者：
Cheung, Michael C.;Perez, Eduardo A.;Koniaris, Leonidas G.
目的探讨原发性胃肠道黑色素瘤（PGIM）的临床特征及预后。方法对1973-2004年的监测、流行病学和最终结果数据库进行分析。2000年PGIM的年发病率约为每百万人0.47例。总的中位生存时间为17个月。肿瘤发生于口鼻咽部（32.8%）、肛管（31.4%）、直肠（22.2%）、食管（5.9%）、胃（2.7%）、小肠（2.3%）、胆囊（1.4%）和大肠（0.9%）。单因素分析显示，年龄、肿瘤部位、分期、手术和淋巴结状况是改善生存率的重要预测因素。位于大肠的肿瘤尚未达到MST，而位于胃的肿瘤显示出最短的中位生存期（5个月）。对于接受手术切除的患者，观察到MST改善。有淋巴结转移者预后较差。队列的多因素分析表明，位置，先进的肿瘤分期，未能进行手术切除，阳性淋巴结的状态，和年龄都是独立的预测较差outcome.Conclusion PGIM发生最常见的口鼻咽和肛管。手术摘除是唯一可确定的治疗方式，显着提高生存率。
Objective The objective of the study was to determine the outcomes for primary gastrointestinal melanomas (PGIM).Material and methods The Surveillance, Epidemiology, and End Results database (1973-2004) was queried.Results Overall, 659 cases of PGIM were identified. The annual incidence of PGIM was approximately 0.47 cases per million in 2000. Overall median survival time was 17 months. Tumors were identified in the oral-nasopharynx (32.8%), anal canal (31.4%), rectum (22.2%), esophagus (5.9%), stomach (2.7%), small bowel (2.3%), gallbladder (1.4%), and large bowel (0.9%). Univariate analysis demonstrated age, tumor location, stage, surgery, and lymph node status were significant predictors of improved survival. MST has not been reached for tumors located in the large bowel, while tumors located in the stomach demonstrated the shortest median survival (5 months). Improvement in MST was observed for those patients undergoing surgical resection. The presence of lymph node involvement conferred a poorer prognosis. Multivariate analysis of the cohort identified that location, advanced tumor stage, failure to undertake surgical resection, positive lymph node status, and age were all independent predictors of poorer outcome.Conclusion PGIM occurs most often in the oral-nasopharynx and anal canal. Surgical extirpation is the only identifiable treatment modality that significantly improves survival.