口腔颌面部恶性黑色素瘤39例临床分析

Clinical analysis of 39 cases of oral and maxillofacial malignant melanoma

目的：总结分析39例原发性口腔颌面部恶性黑色素瘤的临床资料,探讨影响预后的相关因素.方法：收集1998-01～ 2011-06间39例原发性口腔颌面部恶性黑色素瘤患者的临床病理资料,采用Kaplan-Meier法分析临床病理因素与预后的关系.结果：Ⅰ期患者3例,2例生存时间超过了65个月；Ⅱ期、Ⅲ期和Ⅳ期患者的中位生存时间分别为49、38和14个月,差异有统计学意义（P ＜0.001）；单纯接受手术治疗者中位生存时间17个月,手术治疗联合化疗者中位生存时间45个月,手术治疗联合免疫治疗者中位生存时间49个月,手术治疗联合化疗及免疫治疗者中位生存时间54个月,差异有统计学意义（P＜0.001）.结论：口腔颌面部恶性黑色素瘤治疗提倡综合序列治疗,化疗和免疫治疗是目前提倡的有效的辅助治疗方法.

Objective：To study the clinical characteristics of primary oral and maxillofacial malignant melanoma and prognostic factors after treatment.Methods：The clinical records of 39 patients with primary oral and maxillofacial malignant melanoma from January 1998 to June 2011 were retrospectively reviewed.Clinical factors were analyzed for the impact on outcomes by Kaplan-Meier test.Results：The survival time of 2 patients in stage Ⅰ was more than 65 months,and the median survival time of the patients in stage Ⅱ,Ⅲ and Ⅳ was 49,38 and 14 months,respectively（P ＜0.001）.The survival time of the patients treated by surgical operation,surgical operation with immunotherapy,or surgical operation with chemotherapy and immonotherapy were 17,45,49 and 54 months respectively（P ＜ 0.001）.Conclusion：Oral and maxillofacial malignant melanoma should be treated by comprehensive and sequential therapy.Chemotherapy and immunotherapy are currently used effective auxiliary treatments.