Treatment and prognosis of malignant melanoma of the oral cavity: preoperative surgical procedure increases risk of distant metastasis.
OBJECTIVE
Many authors have reported that oral melanoma patients showed much worse prognosis than those with cutaneous melanoma. We investigated treatment method and prognosis of patients with oral malignant melanoma.


METHODS
Twenty-one patients with oral melanoma treated at our hospital were investigated, with special reference to the influence of preoperative surgical procedures such as biopsy, incision, or tooth extraction on the prognosis.


RESULTS
All patients underwent surgery followed by immuno-chemotherapy with dimethyl triazeno imidazole carboxamide (DTIC), ninustine hydrochloride (ACNU), vincristine (VCR), and biologic response modifier OK-432. Local control was obtained in 20 of 21 patients. Lymph node metastasis appeared in 13 patients, but neck failure was not detected in any patients. Distant metastasis occurred in 9 patients in spite of loco-regional control. Five-year survival rate of 12 patients with no preoperative surgical procedure was 91.7%, while that of the 9 patients who had undergone surgical procedures before treatment was 25.9% (P < .05).


CONCLUSIONS
Oral melanoma patients can obtain a prognosis as good as that for cutaneous melanoma patients, when the above-mentioned therapy is used without any preoperative surgical procedures.
Umeda
Masahiro
M
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. m.umeda@hosp.kobe-u.ac.jp
Komatsubara
Hideki
H
Shigeta
Takashi
T
Ojima
Yasutaka
Y
Minamikawa
Tsutomu
T
Shibuya
Yasuyuki
Y
Yokoo
Satoshi
S
Komori
Takahide
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D000075202:Contraindications; D003606:Dacarbazine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007167:Immunotherapy; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D009362:Neoplasm Metastasis / Q000517:prevention & control*; D015376:Nimustine / Q000008:administration & dosage; D010844:Picibanil / Q000627:therapeutic use; D011379:Prognosis; D012307:Risk Factors; D014081:Tooth Extraction; D014750:Vincristine / Q000008:administration & dosage
D015376:Nimustine; D010844:Picibanil; D014750:Vincristine; D003606:Dacarbazine