Comparative analysis of postoperative adjuvant therapy for head and neck mucosal melanoma in China

Abstract

Background

Head and neck mucosal melanoma is a rare malignant disease with no clear and effective treatment to control the prognosis of patients.

Aim

To analyze the effects of different postoperative adjuvant treatments on the survival and prognosis of patients.

Material and methods

A retrospective analysis of 163 patients which were divided into five groups: no adjuvant therapy, postoperative radiotherapy, postoperative chemotherapy, postoperative chemotherapy and radiotherapy, and postoperative immunotherapy. Kaplan–Meier method and Cox regression analysis were used to analyze the prognosis in the different groups.

Results

Postoperative radiotherapy had statistically significant effects on local recurrence, distant metastasis, overall survival, progression-free survival (PFS) and recurrence-free survival (RFS); Postoperative chemotherapy and postoperative chemotherapy/radiotherapy had effects on distant metastasis, overall survival, PFS and RFS. However, postoperative immunotherapy did not show any significant effects. For patients with limited lesions who underwent endoscopic surgery, receive postoperative radiotherapy and postoperative chemotherapy/radiotherapy seem to have better prognosis.

Conclusions and significance

For the head and neck mucosal melanoma, different types adjuvant therapy can prolong the survival of patients to varying degrees compared with no postoperative treatment, but immunotherapy as a single adjuvant therapy does not show any advantages. We recommended that patients should receive radiotherapy and/or chemotherapy after surgery.

Chinese abstract

背景：头颈部黏膜黑色素瘤是一种罕见的恶性病, 尚无明确且有效的治疗方法来控制该病患者的预后。

目的：分析不同术后辅助治疗对患者生存和预后的影响。

材料和方法：对 163 名患者进行了回顾性分析。这些患者被分为五组：无辅助治疗、术后放疗、术后化疗、术后放化疗、术后免疫治疗。 将Kaplan-Meier法和Cox回归分析用于分析不同组的预后。

结果：术后放疗对局部复发、远处转移、总生存期、无进展生存期（PFS）和无复发生存期（RFS）有统计学意义。术后化疗和术后放化疗对远处转移、总生存期、PFS 和 RFS有作用。然而, 术后免疫治疗没有显示任何显著作用。对于接受内镜手术的病变有限的患者, 接受术后放疗和术后化疗/放疗似乎有更好的预后。

结论与意义：对于头颈部黏膜黑色素瘤, 与不进行术后治疗相比, 不同类型的辅助治疗可以不同程度地延长患者的生存期, 但免疫疗法作为单一的辅助治疗并没有显示出任何优势。我们建议患者在手术后接受放疗和/或化疗。

Keywords:

• Mucosal melanoma
• head and neck
• adjuvant therapy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by National Natural Science Foundation of China [82071032].