Prognostic features and clinical panthological factors of mucosal malignant melanoma.

Abstract

e21588 Background: Mucosal malignant melanoma (MMM) is a rare subtype occurring in sites like the gastrointestinal and respiratory tracts. This study aims to analyze the clinicopathological features of MMM patients to assess their impact on prognosis and inform clinical decisions and treatment strategies. Methods: We retrospectively collected data from 180 patients with MMM treated at the Fourth Hospital of Hebei Medical University from January 1, 2013, to June 30, 2024. Key variables included gender, age, metastasis, lymph node involvement, surgery, treatment, and genetic testing. Statistical analysis was performed using SPSS 27.0, with survival curves generated by Kaplan-Meier and multivariate analysis using Cox regression. Results: Of 273 patients, 180 with complete data were included. As of the last follow-up (July 15, 2024), 96 (53.3%) patients had died. The cohort included 73 males (40.6%) and 107 females (59.4%), with 89 (49.4%) under 65 years of age. Metastasis was common, with 26 (14.4%) having organ metastasis, including lung (6.1%), liver (3.9%), and bone (5.6%) involvement. Sixty-six percent underwent surgery, and 51.7% received postoperative adjuvant therapy. Genetic testing in 29 patients revealed mutations in BRAF (2.2%), NRAS (3.3%), and other genes. Survival analysis showed a median overall survival (OS) of 36.7 months. The 1-year, 3-year, 5-year, and 10-year survival rates were 60%, 41%, 33%, and 17%, respectively. Univariate analysis identified advanced age (≥65 years vs < 65 years, median OS 60 vs 24 months, HR 0.54, P = 0.003), organ metastasis (HR 0.48, P = 0.006), lung metastasis (HR 0.24, P < 0.001), absence of surgery (HR 0.49, P < 0.001), absence of adjuvant therapy (HR 0.51, P = 0.002), and advanced tumor stage (HR 1.11, P = 0.017) as significant predictors of poor OS. Multivariate analysis revealed that age (HR 0.60, P = 0.018) and lung metastasis (HR 0.29, P = 0.015) were independent prognostic factors. The absence of adjuvant therapy showed a trend toward worse OS (HR 0.65, P = 0.094). Conclusions: The 5-year survival rate for MMM was 33%, with age and baseline lung metastasis identified as independent prognostic factors for poor OS. These findings highlight the need for improved diagnostic and treatment strategies to enhance prognosis. However, limitations in patient data and treatment protocols suggest that standardized approaches to MMM diagnosis and treatment require further development.