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Treatment modalities in sinonasal mucosal melanoma: A national cancer database analysis

机译:Sinonasal粘膜melanoma的治疗方式:国家癌症数据库分析

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Objectives/Hypothesis The purpose of this study was to investigate the association of demographic factors, tumor stage, and treatment modalities for overall survival in patients with sinonasal mucosal melanoma (SNMM). Study Design Retrospective database review. Methods The National Cancer Database was queried for patients of all ages with SNMM between 2004 and 2015. Univariate Kaplan‐Meier and multivariate Cox regression analyses were performed to evaluate the association of suspected prognostic factors with overall survival. Results A total of 1,874 patients with SNMM were included in the analysis. The 5‐year overall survival was 24%. Prognostic factors associated with decreased survival include advanced age (hazard ratio [HR]: 1.02, 95% confidence interval [CI]: 1.01‐1.03), T4 disease (HR: 1.44, 95% CI: 1.09‐1.89), and presence of distant metastases (HR: 3.22. 95% CI: 2.06‐5.04). Improved survival was associated with surgical resection only when margins were negative (HR: 0.44; 95% CI: 0.30‐0.65). In patients with metastatic disease, administration of immunotherapy (HR: 0.14; 95% CI: 0.04‐0.49) was associated with improved survival. Surgical approach, radiotherapy, and chemotherapy were nonsignificant predictors of survival. Conclusions This investigation is the largest to date to analyze the association of treatment modalities with overall survival in SNMM. Surgery remains the mainstay of treatment in patients with SNMM. However, administration of immunotherapy may confer survival benefit to patients with metastatic disease. Level of Evidence NA Laryngoscope , 130:275–282, 2020
机译:目的/假设本研究的目的是调查人口统计因子,肿瘤阶段和治疗方式的整体存活的协会,在患有Sinonasal粘膜黑素瘤(SNMM)的患者中。研究设计回顾性数据库审查。方法对全国癌症数据库有针对2004年至2015年间SNMM的所有年龄患者询问。进行单变量Kaplan-Meier和多元COX回归分析,评价涉嫌预后因素的关联。结果分析中共有1,874例SNMM患者。 5年的整体生存率为24%。与生存率下降相关的预后因素包括晚期(危险比[HR]:1.02,95%置信区间[CI]:1.01-1.03),T4疾病(HR:1.44,95%CI:1.09-1.89)和存在远处转移(HR:3.22。95%CI:2.06-5.04)。仅当边距为阴性时,改善的存活与手术切除有关(HR:0.44; 95%CI:0.30-0.65)。在转移性疾病患者中,免疫疗法施用(HR:0.14; 95%CI:0.04-0.49)与提高存活相关。手术方法,放疗和化疗是不显着的存活预测因子。结论本调查是迄今为止,分析SNMM整体存活的治疗方式结合。手术仍然是SNMM患者治疗的主干。然而,免疫疗法的给药可能会赋予转移性疾病患者的生存效益。证据Na Laryngocupt,130:275-282,2020

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