Hahn Hyung Min, Lee Kyoung Geun, Choi Won, Cheong Seung Hyun, Myung Ki Bum, Hahn Hyung Jin
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Gyeonggi 16499, Republic of Korea.
Department of Dermatology, College of Medicine, Konyang University, Daejeon, Chungcheongnam 35365, Republic of Korea.
Mol Clin Oncol. 2019 Aug;11(2):116-126. doi: 10.3892/mco.2019.1870. Epub 2019 May 29.
Mucosal melanoma (MM) is a highly lethal variant of melanoma that carries a poor prognosis. Extremely low incidence and survival rates have led to few clinical trials, and a lack of protocols and guidelines. The present study performed a survival meta-analysis for the quantitative synthesis of available evidence to search for key patterns that would help clinicians tailor optimal therapeutic strategies in MM. PubMed, EMBASE, Cochrane, MEDLINE, Google Scholar and other databases were searched. Hazard ratios, in disease-specific and overall survival, were calculated for each of the survival-determining variables. MM was 2.25 times more lethal than cutaneous melanoma (CM). The most significant threats to survival were advanced Tumor-Node-Metastasis stage, sino-nasal location, and old age. Chemotherapy was the most effective form of adjuvant therapy. Disease-specific survival, the primary measure of the effect sizes, can fluctuate depending on the accuracy of the reported cause of mortality. In conclusion, MM is a peculiar type of melanoma, with clinical and molecular profile vastly different from the much-familiar CM. In the wake of the era of precision oncology, further studies on driver mutations and oncogenic pathways would likely lead to improved patient survival.
黏膜黑色素瘤(MM)是黑色素瘤的一种高度致死性变体,预后较差。极低的发病率和生存率导致临床试验较少,且缺乏方案和指南。本研究进行了一项生存荟萃分析,以定量综合现有证据,寻找有助于临床医生为MM患者量身定制最佳治疗策略的关键模式。检索了PubMed、EMBASE、Cochrane、MEDLINE、谷歌学术等数据库。计算了每个生存决定变量在疾病特异性生存和总生存方面的风险比。MM的致死性是皮肤黑色素瘤(CM)的2.25倍。对生存的最显著威胁是晚期肿瘤-淋巴结-转移分期、鼻窦部位和老年。化疗是辅助治疗最有效的形式。疾病特异性生存作为效应大小的主要衡量指标,可能会因报告的死亡原因的准确性而波动。总之,MM是一种特殊类型的黑色素瘤,其临床和分子特征与人们熟知的CM有很大不同。在精准肿瘤学时代,对驱动突变和致癌途径的进一步研究可能会提高患者生存率。