The Management and Site-Specific Prognostic Factors of Primary Oral Mucosal Malignant Melanoma. Issue 2 (March 2015)

• Record Type: Journal Article
• Authors: Wushou, Alimujiang; Zhao, Ya-Jun
• Is Part Of: Journal of craniofacial surgery. Volume 26:Issue 2(2015)
• Publication Date: 2015-03
• Subjects: Facial bones -- Surgery -- Periodicals; Skull -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Surgery, Plastic -- Periodicals; 617.52
• DOI: 10.1097/SCS.0000000000001328
• Languages: English
• ISSNs: 1049-2275

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Abstract</title> <p>Primary oral mucosal malignant melanoma (POMM) is uncommon. Its biological behavior is more aggressive than that of cutaneous malignant melanoma. Its site-specific prognostic factors and optimal management have not been determined yet. Retrospective POMM case analysis from peer-reviewed publications in the PubMed and Embase electronic database from January 1984 to December 2013, in which therapy and outcome data were available, was performed. A total of 151 primary cases were extracted from 39 peer-reviewed English literatures. The study population includes 63 males and 88 females with a medium age of 61 years. The treatment protocols include surgery alone (18%), radiotherapy alone (14%), surgery plus radiotherapy (14%), surgery plus chemotherapy (31%), as well as surgery plus chemoradiotherapy (15%) and chemoradiotherapy (8%). The male patients have a higher risk for metastasis than the female patients do (odds ratio [OR]; 3.41, <italic>P</italic> = 0.021). The POMM originating from specialized mucosa was associated with increased risk for tumor recurrence and mortality (OR, 4.03, <italic>P</italic> = 0.001; OR, 2.03, <italic>P</italic> = 0.031, respectively). The patients who had surgery-based multiple therapy have a significantly longer survival compared with those who had surgery alone and those who had no surgical treatment (<italic>P</italic> = 0.000). The age of 60 years or younger (hazard ratio [HR], 4.69; <italic>P</italic> = 0.000), nonsurgical treatment (HR, 12.838; <italic>P</italic> = 0.000), and surgery alone (HR, 1.517; <italic>P</italic> = 0.001) were independent adverse prognostic factors for overall survival. Taken together, the study results suggest that surgery-based multiple therapy is the most effective treatment protocol. The age of 60 years, nonsurgical treatment, and surgery alone were independent adverse prognostic factors for overall survival.</p> </sec> </abstract>