鼻腔鼻窦黏膜黑色素瘤的治疗和预后

Treatment and prognosis of sinonasal mucosal melanoma

目的:探讨鼻腔鼻窦黏膜黑色素瘤(SMM)的治疗和预后影响因素。方法:对1976-01-2005-12收治的68例SMM患者的临床病理和随访资料进行单因素和多因素分析。结果:68例SMM患者,总的3年、5年生存率分别为36.1%、29.4%;单因素分析显示首次就诊时无淋巴结转移、无远处转移、接受手术治疗或生物治疗者预后较好;多因素分析显示患者首诊时出现远处转移、残留/复发者预后差;患者接受手术治疗或生物治疗后可显著改善预后。结论:SMM预后差,有远处转移或肿瘤残留/复发者预后更差;手术治疗和生物治疗有利于改善其预后。

Objective：To evaluate the treatment and prognosis of sinonasal mucosal melanoma（SMM）. Method： Clinicopathological data of SMM patients from January 1976 to December 2005 were analyzed retrospectively. Survival analysis was performed and Kaplan-Meier analysis was used to compare the effect of clinicopathological factors on survival using SPSS 18.0 software. A Cox model was applied for multivariate analysis. Result： The 3 year and 5-year overall survival（OS） rates of 68 eases of SMM were 36.1; and 29.4;, respectively. The 3-year and 5-year OS of patients who underwent surgery or biotherapy were significantly higher than that of patients who underwent other therapeutic regimens without surgery or without biotherapy, respectively. Multivariate analysis showed the patients with distant metastasis at first present or residual/recurrence had a worse prognosis than that without distant metastasis or residual/recurrence, respectively. Surgery and biotherapy were effective treatments for SMM. Conclusion：SMM has a poor prognosis, especially in the patients with distant metastasis or residual/recurrenee. Surgery or biotherapy may improve the prognosis of patients with SMM.