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Abstract
Objective: The optimal surgical approach for sinonasal mucosal melanoma (SNM) remains under debate. We aimed to compare the therapeutic efficacy of traditional open resection and endoscopic surgery for patients with SNM treated at a single center.
Methods: Thirty-three patients diagnosed with SNM who underwent surgery between January 1995 and June 2014 at a single institution were retrospectively analyzed; 18 patients were treated using an open resection approach and 15 using an endoscopic resection approach for the primary tumor. The associations between open resection and endoscopic resection with treatment-related survival outcomes were assessed using the Kaplan–Meier method and log-rank test.
Results: The most common presenting symptoms were epistaxis and abstraction; the nasal cavity was the most common anatomic location. The open resection and endoscopic resection groups did not have significantly different demographic or tumor characteristics. Overall survival (p = .66) and disease-free survival (p = .73) were modest and did not differ significantly between the open resection and endoscopic resection groups.
Conclusions: This retrospective study indicates that the endoscopic endonasal approach is an effective treatment for SNM in selected cases and, when performed by a skilled surgeon, can enable successful radical resection with a similar efficacy as traditional open resection.
Chinese abstract
目的: 鼻窦粘膜黑色素瘤 (SNM) 的最佳手术方法仍处于辩论之中。我们旨在比较传统开刀切除术和内镜手术对在同一个治疗中心的SNM患者的治疗效果。
方法: 回顾性分析了1995年1月至2014年6月在同一治疗机构接受手术的33例SNM患者; 为治疗原发性肿瘤, 18例患者接受开刀切除术, 15例患者使用内镜切除术。使用Kaplan-Meier方法和对数秩检验评估, 对开刀切除术和内窥镜切除术与治疗相关生存结果之间的相关性进行评估。
结果: 最常见的表现症状是鼻出血和抽搐;鼻腔是最常见的解剖位置。开刀切除组和内镜切除组没有显著的人口组成或肿瘤特征方面的区别。总体生存率 (p = 0.66) 和无病生存率 (p = 0.73) 较低, 并且在开刀切除组和内窥镜切除组之间没有显著差异。
结论: 这项回顾性研究表明, , 当由熟练的外科医生施行时, 内镜鼻内法是对所选SNM病例的有效治疗方法, 可以成功实现根治性切除, 具有与传统开刀切除术相似的功效。
Disclosure statement
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.