Characteristics and prognostic analysis of oral mucosal melanoma with lung metastasis

doi:10.19401/j.cnki.1007-3639.2022.12.006

Abstract

Abstract:

Background and purpose: Oral mucosal malignant melanoma (OMM) is a highly malignant solid tumor with a distant metastasis rate of about 40%. The lung is the most common metastatic site. This study aimed to investigate the characteristics and prognostic analysis of OMM with lung metastasis, in order to find the best treatment mode for OMM with lung metastasis. Methods: The data of the patients with lung metastasis diagnosed in the Ninth People’s Hospital Affiliated to the Medical College of Shanghai Jiao Tong University from January 2017 to January 2021 were retrospectively analyzed. The imaging characteristics of chest computed tomography (CT) were summarized, and Kaplan-Meier method was used for survival analysis. Results: In this study, 88% of patients with OMM were diagnosed with lung metastasis within 2 years after operation, including 22 cases (52%) in the first year and 15 cases (36%) in the second year; 71% of patients showed multiple, round or oval nodules of different sizes on chest CT, and few single metastases (10%). Non-scheduled follow-up (P = 0.009), concurrent local recurrence (P = 0.037), concurrent pleural effusion (P = 0.042) and no immunotherapy (P = 0.000) could significantly reduce the survival time of patients. The response of patients with relapse to programmed death-1 (PD-1) immunotherapy was significantly reduced (P = 0.009), and the median overall survival (OS) of PD-1 single drug was only 10 months. After combination therapy with PD-1 and anti-vascular targeted drugs, the median OS could be increased to about 19 months (P = 0.019). Conclusion: OMM is prone to lung metastasis, and even tiny nodules less than 1cm can be metastatic foci. The metastasis of OMM most often occurs within 1-2 years after operation. Regular follow-up can detect early metastasis and significantly prolong the survival. The efficacy of immunotherapy alone for recurrent and metastatic OMM is also poor, and immunotherapy combined with anti-vascular targeted therapy is required.

Key words: Oral, Mucosal melanoma, Lung metastasis, Relapse, Follow-up

CLC Number:

R739.8

HAN Ruxue, LIANG Xiang, MA Xuhui, GUO Wei, WU Yunteng, REN Guoxin. Characteristics and prognostic analysis of oral mucosal melanoma with lung metastasis[J]. China Oncology, 2022, 32(12): 1184-1189.

Figures/Tables 5

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Variable	Case n	Median OS t/month	P value
Gender			0.991
Male	23	14.3±2.3
Female	19	16.8±3.4
Age/year			0.288
<50	17	15.6±3.6
≥50	25	15.3±2.3
Clinical stage			0.075
Ⅲ	12	23.5±5.0
Ⅳ	30	13.0±2.0
Regular follow-up			0.009
Yes	14	24.8±3.6
No	28	11.3±2.0
Local recurrence			0.037
Yes	30	12.6±1.9
No	12	25.2±5.2
Maximum diameter of nodule/cm			0.295
<2	24	18.4±3.6
≥2	46	14.1±2.5
Pleural effusion			0.042
Yes	6	7.2±1.4
No	36	17.6±2.5
Extrapulmonary metastasis			0.751
Yes	8	17.4±5.8
No	34	15.1±2.1
Therapies			0.000
Chemotherapy alone	13	4.6±0.3
Combined immunotherapy	29	19.9±2.6