Outcomes in Patients With Mucosal Melanomas
Outcomes in Patients With Mucosal Melanomas
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DOI：
10.1002/jso.23445
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发表时间：
2013-12-01
影响因子：
2.5
通讯作者：
Farma, Jeffrey M.
中科院分区：
文献类型：
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作者：
Keller, Deborah S.;Thomay, Alan A.;Farma, Jeffrey M.
我们的目标是评估不同亚型的粘膜黑色素瘤和描述特定的变量，预测outcome.MethodsProspective审查两个三级保健中心的数据库确定了76例粘膜黑色素瘤患者，73个完整的记录。分析人口统计学和临床数据。考克斯回归确定变量影响复发和survival.ResultsIn的73例患者，平均年龄为64岁，74%是女性。67%的患者有淋巴结受累，73%的患者有溃疡性肿瘤。主要受累部位为鼻/腭/口腔（36%）、外阴/阴道/宫颈（48%）和肛门直肠（15%）。平均总生存期和无病生存期分别为56.9和27.2个月。与生存率降低相关的变量包括：淋巴管浸润（HR 17.70，P=0.0093），高加索人种（HR 3.02，P=0.0362），鼻/腭/口亚组（HR1.85，P=0.026）、Breslow厚度（HR1.23，P=0.00004）、T分期（HR1.34，P=0.0075）、M分期（HR3.03，P=0.0039）和化疗（HR3.13，P=0.0002）。鼻/腭/口腔亚组的预后最差，中位总生存期为9.7个月，无复发时间为4.5个月。这种亚型也表现出高淋巴结阳性，溃疡，和更大的肿瘤size.ConclusionThe鼻，腭，口腔亚型有最差的预后相比，其他粘膜黑色素瘤的位置。正在进行研究，以评估可能预测结果的病理和基因组变量。外科肿瘤学杂志2013; 108：516-520。(c)2013 Wiley Periodicals，Inc.
Background and ObjectiveOur goal was to evaluate the different subtypes of mucosal melanoma and describe specific variables that predict outcomes.MethodsProspective review of two tertiary care center databases identified 76 mucosal melanoma patients; 73 with complete records were included. Demographic and clinical data were analyzed. Cox regression determined variables impacting recurrence and survival.ResultsIn the 73 patients, the mean age was 64 years, and 74% were female. Sixty-seven percent presented with lymph node involvement, and 73% had ulcerated tumors. Major sites affected were nasal/palate/oral (36%), vulvar/vaginal/cervical (48%), and anorectal (15%). Mean overall and disease-free survival were 56.9 and 27.2 months. Variables associated with decreased survival included: lymphovascular invasion (HR17.70, P=0.0093), Caucasian race (HR3.02, P=0.0362), nasal/palate/oral sub-group (HR1.85, P=0.026), Breslow thickness (HR1.23, P=0.00004), T stage (HR1.34, P=0.0075), M stage (HR3.03, P=0.0039), and chemotherapy (HR3.13, P=0.0002). The worst prognosis was seen in the nasal/palate/oral sub-group, with a median overall survival of 9.7 months and recurrence-free time of 4.5 months. This subtype also demonstrated high lymph node positivity, ulceration, and larger tumor size.ConclusionThe nasal, palate, oral subtype has the worst prognosis compared to other mucosal melanoma locations. Studies are ongoing to evaluate pathologic and genomic variables that may predict outcomes. J. Surg. Oncol. 2013; 108:516-520. (c) 2013 Wiley Periodicals, Inc.