肛管直肠恶性黑色素瘤手术后转移的相关临床病理因素分析

The analysis of clinical and pathological factors related to surgical metastatic anorectal malignant melanoma

目的探讨肛管直肠恶性黑色素瘤手术后转移的相关临床病理特征和预后的相关因素,为临床治疗提供理论基础。方法回顾性分析2009—2019年间辽宁省肿瘤医院、哈尔滨医科大学附属肿瘤医院和中山大学肿瘤防治中心结直肠科诊断为肛管直肠恶性黑色素瘤术后转移的52例患者的临床基础资料。采用Log-rank检验和Cox模型分别进行单因素和多因素分析,比较不同临床病理因素对患者总生存的影响。结果随访时间为120个月,Log-rank单因素分析结果显示T分期、有无辅助治疗、转移瘤数目是影响肛管直肠恶性黑色素瘤手术后转移预后的相关因素,而Cox多因素分析结果表明T分期(OR=2.351,P=0.038)、有无辅助治疗(OR=0.073,P=0.041)、转移瘤数目(OR=0.545,P=0.016)是影响外科手术后肛管直肠恶性黑色素瘤预后的独立因素。结论T分期、有无辅助治疗、转移瘤数目是影响肛管直肠恶性黑色素瘤的预后因素。依据患者情况及预后的相关因素,及时调整治疗模式可能延长患者的总生存时间。

Objective To investigate the clinicopathological characteristics and prognostic factors of metastatic anorectal malignant melanoma after surgery.Methods A retrospective analysis of 52 patients diagnosed with metastatic anorectal malignant melanoma after surgery from January 2009 to January 2019 from Liaoning Cancer Hospital,Harbin Medical University Affiliated Tumor Hospital and Sun Yat-sen University Cancer Center.Log-rank test and cox model were used to conduct univariate and multivariate analysis to compare the impact of different clinical factors on the overall survival of patients.Results The follow-up period was 120 months.Log-rank univariate analysis showed that T stage,adjuvant therapy and the number of metastases were the influencing factors for the prognosis of metastatic anorectal malignant melanoma after surgery.T stage(OR=2.351,P=0.038),adjuvant therapy(OR=0.073,P=0.041)and the number of metastatic tumors(OR=0.545,P=0.016)were the independent factor for the metastatic anorectal malignancy melanoma.Conclusions T stage,adjuvant therapy and the number of metastases are independent factors that affected the prognosis of metastatic anorectal malignant melanoma after surgery.According to the patient’s condition and prognostic factors,adjustment of the treatment mode could prolong the patient’s overall survival time.