Mucosal Melanoma of the Nose and Paranasal Sinuses, a Contemporary Experience From The M. D. Anderson Cancer Center
Mucosal Melanoma of the Nose and Paranasal Sinuses, a Contemporary Experience From The M. D. Anderson Cancer Center
复制标题
DOI：
10.1002/cncr.24976
复制
发表时间：
2010-05-01
期刊：
影响因子：
6.2
通讯作者：
Hanna, Ehab Y.
中科院分区：
文献类型：
--
作者：
Moreno, Mauricio A.;Roberts, Dianna B.;Hanna, Ehab Y.
背景：鼻窦黏膜黑色素瘤是一种罕见的疾病，预后很差。由于该系列中的大多数都追溯了几十年，我们试图通过最近的治疗方式来确定预后因素和结果。方法：回顾1993-2004年间在三级癌症中心接受治疗的58例鼻腔黑色素瘤患者的病历。根据美国鼻腔肿瘤联合委员会(AJCC)的分期系统对患者进行回顾性分期。确定人口统计学、临床和病理参数，并与结果相关。结果：本组病例中男性35例，女性23例，中位年龄63岁，手术治疗56例，放射治疗33例。根据Ballantyne的临床分期系统，88%的患者表现为I期(局部)疾病。按AJCC分期分类，27%的患者为11岁，33%为T2，21%为T3，19%为T4。T分期和肿瘤色素沉着程度与较差的生存率相关(P=.0096和P=.018)，而假乳头状结构与较高的局部失败率相关(P=.0144)。当总剂量大于54Gy时，术后放射治疗改善了局部区域控制(P=.0215)，但不影响总存活率。结论：根据鼻腔AJCC分期系统的肿瘤分期是一个有效的预后预测指标，应作为选择的分期系统。术后放射治疗可提高局部控制率，但需采用较高剂量和标准分割。组织学特征，如色素沉着和假乳头状结构，与较差的预后相关。癌症2010；116：2215-23。(C)2070年美国癌症协会
BACKGROUND: Sinonasal mucosal melanoma is a rare disease associated with a very poor prognosis. Because most of the series extend retrospectively several decades, we sought to determine prognostic factors and outcomes with recent treatment modalities. METHODS: A retrospective chart review of 58 patients treated for sinonasal melanoma at a tertiary cancer center between 1993 and 2004. The patients were retrospectively staged according to the sinonasal American Joint Committee on Cancer (AJCC) staging system. Demographic, clinical and pathological parameters were identified and correlated with outcomes. RESULTS: There were 35 males and 23 females with a median age of 63 years; 56 patients were treated surgically and 33 received radiation therapy. According to Ballantyne's clinical staging system, 88% of the patients presented with stage I (local) disease. Classification by the AJCC staging classified yielded 27% of the patients with 11, 33% with T2, 21% with T3, and 19% with T4. T-stage and the degree of tumor pigmentation were associated with a worse survival (P = .0096 and P = .018, respectively), while pseudopapillary architecture was associated with a higher locoregional failure (P = .0144). Postoperative radiation therapy improved locoregional control when a total dose greater than 54 Gy was used (P = .0215), but did not affect overall survival. CONCLUSIONS: Tumor stage according to sinonasal AJCC staging system is an effective outcome predictor and should be the staging system of choice. Postoperative radiation therapy improves locoregional control when a higher dose and standard fractionations are used. Histological features such as pigmentation and pseudopapillary architecture are associated with worse outcome. Cancer 2010;116:2215-23. (C) 2070 American Cancer Society