Analysis Of Prognostic Factors Of Head And Neck Mucosal Melanoma

Research purposesMucosa melanoma of head and neck is a clinically rare tumor.The tumor is highly invasive and has a high degree of malignancy.This study collected clinical data of 51 MMHN patients,retrospectively analyzed the characteristics of clinicopathological characteristics and survival prognostic factors,and provided a theoretical basis for improving the effectiveness of MMHN comprehensive treatment and improving survival prognosis.Research methodsThrough postoperative follow-up,the clinical data of 51 patients with melanoma of the head and neck mucosa were retrospectively analyzed.All cases were hospitalized in our hospital from January 2007 to January 2017,and were confirmed by histopathology and immunology.Collect the patient's morbidity,diagnosis and treatment process,organize and analyze the patient's gender,age,primary tumor site,AJCC clinical stage,postoperative lymphatic metastasis,postoperative radiotherapy,chemotherapy,targeted treatment,postoperative local recurrence and whether it occurs Clinical data such as distant metastasis and follow-up survival time.Kaplan-Meier method was used for survival analysis,survival curve was drawn,and 3-year survival rate and 5-year survival rate were calculated.Log rank test is used for single factor analysis between groups.The risk factors of survival rate were discussed.The risk factors of statistical difference were analyzed by multi-factor regression through COX test,and the related risk factors that affected the survival prognosis,postoperative local recurrence and distant metastasis were clearly identified.P<0.05 believed that the differences between related factors were statistically significant.Research result1.A total of 51 patients with melanoma of the head and neck mucosa were included in this study,including 34 patients with nasal sinus mucosa melanoma,15 patients with oral mucosa melanoma,1 patient with nasopharyngeal mucosal melanoma and 1 patient with laryngomucosal melanoma.Among them,28 were male and 23 were female.Male:female=1.22:1,the age of onset of diagnosis was 28-95 years old,the age of high incidence was 50-70 years old,accounting for 66.7%(34/51),the median age of onset was 61 year old.According to the AJCC staging,the included 51 cases included:26 patients with stage ?,15 patients with stage IVA,9 patients with stage IVB and 1 patient with stage IVC.Fifty-one patients with MMHN underwent surgical treatment to remove the tumor tissue,Among them,23 cases received postoperative radiotherapy and 8 cases received targeted drug therapy.The follow-up period ended in December 2019,ranging from 36 months to 156 months,with a median follow-up period of 69 months2.Kaplan Meier survival curve analysis:the 3-year survival rate,5-year survival rate and median survival time were 43.1%(22/51),25.5%(10/39)and 26 months respectively.Of the 51 patients,29 died and 22 survived.The average survival time was 38 months.3.The local recurrence rate of patients with melanoma of the head and neck mucosa was 23.5%(12/51).The single factor analysis by Log-rank method showed that:AJCC stage,postoperative radiotherapy,distant metastasis and postoperative auxiliary target The difference between treatments has a certain correlation with the local recurrence rate of patients(P<0.05);multivariate regression analysis by COX test shows that distant metastasis is a risk factor for local recurrence after surgery.4.51 patients with head and neck mucosal melanoma had a postoperative distant metastasis rate of 29.4%(15/51).After log-rank method for univariate analysis,the results showed:AJCC stage,lymph node metastasis,local recurrence and postoperative Assisted radiotherapy has statistical significance on the patient's distant metastasis rate(P<0.05).Postoperative radiotherapy is conducive to controlling local recurrence and reducing the incidence of distant metastasis;multifactor regression analysis through COX test can know the original time The high AJCC stage of tumors and local recurrence after operation are the risk factors for patients with distant metastasis after operation5.The survival prognosis of 51 head and neck mucosal melanoma patients was determined by Kaplan-Meier survival analysis:the survival rate of head and neck mucosal melanoma and four factors,namely:primary tumor AJCC stage,local recurrence after surgery,distant The difference between metastasis and effective targeted therapy after surgery was statistically significant(P<0.05).By further incorporating these four factors into the COX test and conducting multivariate regression analysis,it can be seen that effective postoperative targeted therapy is a factor that is conducive to the survival prognosis of the patient;the primary AJCC stage of the primary tumor,high local recurrence,and distant metastasis affect the survival of the patient Risk factors for prognosis.ConclusionIn this study,we retrospectively analyzed the clinical and pathological characteristics of 51 cases of head and neck mucosal melanoma,followed the 3-year and 5-year survival rates of patients,and explored the risk factors affecting the survival prognosis,local recurrence,and distant metastasis.The main conclusions are as follows:(1)Men with melanoma of the head and neck mucosa have slightly more men than women.The most common age of onset is 50-70 years old,and the most common site is the mucosa of the nasal cavity and sinuses;(2)Part of the patients with melanoma of the head and neck mucosa The recurrence rate and distant metastasis rate are high,so its 3-year and 5-year survival rates are low;(3)Local recurrence and distant metastasis are the risk factors of poor prognosis in patients with primary AJCC.Effective target therapy after operation is helpful to improve the prognosis and survival rate of patients.(4)Local recurrence is a risk factor for distant metastasis.For patients with local recurrence,the whole body should be checked as early as possible to determine whether there is distant metastasis,so as to carry out targeted treatment in time.