title: The management and site-specific prognostic factors of primary oral mucosal malignant melanoma.
abstract: 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, P = 0.021). The POMM originating from specialized mucosa was associated with increased risk for tumor recurrence and mortality (OR, 4.03, P = 0.001; OR, 2.03, P = 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 (P = 0.000). The age of 60 years or younger (hazard ratio [HR], 4.69; P = 0.000), nonsurgical treatment (HR, 12.838; P = 0.000), and surgery alone (HR, 1.517; P = 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.
authors: From the *Cancer Research Institute, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai; and †Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Xi'an Jiao Tong University, Xi'an, People's Republic of China.
authors: Alimujiang
authors: A
authors: Wushou
authors: Ya-Jun
authors: YJ
authors: Zhao
mesh_terms: D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery*; D009061:Mouth Mucosa / Q000601:surgery*; D009062:Mouth Neoplasms / Q000601:surgery*; D020360:Neoadjuvant Therapy; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate