中国人口腔黏膜黑色素瘤临床诊治专家共识

Expert consensus on clinical diagnosis and treatment for Chinese oral mucosal melanoma

头颈黏膜黑色素瘤(HNMM)是一类高度恶性的实体肿瘤,5年生存率长期徘徊在20%左右,其致病因素、驱动基因、临床表现及治疗手段等与皮肤黑色素瘤差异较大。2015年,国内首个头颈黏膜黑色素瘤诊治专家共识建立,经过6年多的推广应用,HNMM临床诊治规范性有了很大提高。随着黏膜黑色素瘤临床与基础研究的不断深入,HNMM的诊治与预后在近些年发生了较大变化,特别是头颈部各分支学科的蓬勃发展,口腔、鼻腔鼻窦、眼部等黏膜黑色素瘤各自发展出独特的诊治模式,该共识已不能满足当前临床的实际需求。对此,专家组认为头颈部黏膜包含的解剖范围较广,涉及的临床科室较多,不同学科之间黑色素瘤诊疗模式差异明显,临床亟须符合个体化治疗及精准治疗的更加专科化的诊治共识。为了进一步提高口腔黏膜黑色素瘤(OMM)的远期生存率和生存质量,让共识更好地指导临床工作,专家组聚焦OMM,深入讨论,基于循证医学证据和经验医学,完成专家共识的制定。考虑到患者的个体化差异,本共识可作为OMM临床实践的参考。

Head and neck mucosal melanoma(HNMM)is a kind of highly malignant solid tumor.The 5-year survival rate of HNMM is about 20%for a long time.Its pathogenic factors,driving genes,clinical manifestations and treatment methods are quite different from skin melanoma.In 2015,the first Chinese expert consensus on the diagnosis and treatment of head and neck mucosal malignant melanoma was established.After more than six years of application,the clinical diagnosis and treatment of HNMM has been greatly improved.With the deepening of clinical and basic research on mucosal melanoma,the diagnosis,treatment and prognosis of HNMM have changed greatly in recent years,especially with the vigorous development of various branches of head and neck.Oral,nasal,sinus,eye and other mucosal melanoma have developed their own unique diagnosis and treatment model.This consensus can’t meet the actual needs of the current clinical practice.In this regard,the expert group believes that head and neck mucosa contains a wide range of anatomy,involving more clinical departments,and the diagnosis and treatment mode of melanoma varies significantly between different disciplines.It is urgent to meet the clinical consensus of more specialized diagnosis and treatment of individualized treatment and precise treatment.In order to further improve the long-term survival rate and quality of life of oral mucosal melanoma(OMM)and make the consensus to better guide clinical work,this expert group will focus on OMM and conduct in-depth discussion,and establish expert consensus based on evidence-based medicine and empirical medicine.Considering the individual differences of patients,this consensus can be used as a reference for clinical practice of OMM.