Analysis of prognostic factors of primary mucosal melanoma in nasal and oral cavity

Abstract

Primary mucosal melanoma of nasal and oral cavity is a rare tumor with a poor prognosis. This study aims to summarize the clinical features and survival status and then to evaluate the prognostic factors. Clinical data of 66 patients with mucosal melanoma in nasal and oral cavity treated from Jan. 1980 to Jan. 2005, were retrospectively reviewed. All patients received the surgery. The following parameters: gender, age, primary location, tumor size, presence of ulcer, presence of pigment aggravation, lymph node metastasis, treatment mode and initially treatment outcome were investigated to evaluate their potential impact on survival. Kaplan-Meier method and Log-rank test were used for survival analysis. Cox proportional hazards regression was used for multivariate analysis. The primary locations were nasal cavity (34 cases), oral cavity (23 cases) and paranasal sinuses (9 cases). All patients received surgery. Thirty-seven patients received post-operative adjuvant treatments. Of which, 12 received adjuvant chemotherapy. 8 received adjuvant immunotherapy, 5 received adjuvant chemotherapy and immunotherapy, 8 received adjuvant radiotherapy and 4 received adjuvant radiotherapy and chemotherapy. Local recurrence, lymph node metastasis or distant metastasis appeared in 15 patients at 6 months after the primary treatment. The distant metastasis rate was 15.2% (10/66). The average survival time was 77.9 months, the median survival time was 33.7 months. The 3-year and 5-year overall survival rates were 41.4% and 31.1% respectively. Multivariate analysis showed that tumor size, lymph node metastasis and initially treatment outcome were significant prognostic factors for overall survival. The prognosis of mucosal melanoma in nasal and oral cavity is poor. Tumor size, lymph node metastasis, initially treatment outcome are independent prognostic factors for overall survival. The effect of post-operative adjuvant treatments is not clear, and further studies are needed.