Abstract:

Objective To determine the clinical presentation and outcome of patients with mucosal melanoma in China. Methods The elements of the database included basic demographic data of patients and prognosticators previously reported in literature，as well as the follow-up data including clinical outcome after treatment. The American Joint Committee on Cancer（AJCC）staging system（7th edition） was used for either clinical or pathological staging. Medical record of all patients with pathologically diagnosed mucosal melanoma consulted in our center since 2006 were retrieved and reviewed. Statistical analyses including survival and multivariate analyses of factors associated with survival were respectively performed by Kaplan-Meier method and Cox proportional hazard model. Results A total of 212 cases of mucosal melanoma were identified and reviewed.The mean age was 55.8 years with male-to-female ratio 1∶1.46. Head and neck was the most common site（45.3％）.Bleeding was the most common initial symptom（40.6％）. In their primary lesion, 49.5％ of patients had definitive ulceration with a median thickness 3.8mm （0.6-16.0mm）. Lung（55.2％）was the most common metastatic site. The mainstay of therapy for mucosal melanoma was still surgery. The 1-, 2- and 5-year overall survival（OS）rates were 83.7%, 68.3％ and 26.1％，with a median OS of 33.0 months （95％ CI: 22.9-43.1months）.The results of multivariate analysis indicated that stage at diagnosis and serum lactate dehydrogenase（LDH）level were two significant predictive factors for OS, while the application of adjuvant therapy and LDH were the independent factors influencing disease free survival（DFS）. Conclusion Head and neck was the most common primary site of mucosal melanoma. In their primary lesion half of patients had definitive ulceration and got a much thicker tumor invasion. Clinical staging was significantly associated with clinical outcome in terms of OS，and the use of adjuvant therapy could significantly improve the DFS of patients with stage Ⅰ-Ⅲ.