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. 2019 Aug;11(2):116-126.
doi: 10.3892/mco.2019.1870. Epub 2019 May 29.

An updated review of mucosal melanoma: Survival meta-analysis

Hyung Min Hahn  1 , Kyoung Geun Lee  2 , Won Choi  2 , Seung Hyun Cheong  2 , Ki Bum Myung  2 , Hyung Jin Hahn  2   3
Affiliations

An updated review of mucosal melanoma: Survival meta-analysis

Hyung Min Hahn et al. Mol Clin Oncol. 2019 Aug.

Abstract

Mucosal melanoma (MM) is a highly lethal variant of melanoma that carries a poor prognosis. Extremely low incidence and survival rates have led to few clinical trials, and a lack of protocols and guidelines. The present study performed a survival meta-analysis for the quantitative synthesis of available evidence to search for key patterns that would help clinicians tailor optimal therapeutic strategies in MM. PubMed, EMBASE, Cochrane, MEDLINE, Google Scholar and other databases were searched. Hazard ratios, in disease-specific and overall survival, were calculated for each of the survival-determining variables. MM was 2.25 times more lethal than cutaneous melanoma (CM). The most significant threats to survival were advanced Tumor-Node-Metastasis stage, sino-nasal location, and old age. Chemotherapy was the most effective form of adjuvant therapy. Disease-specific survival, the primary measure of the effect sizes, can fluctuate depending on the accuracy of the reported cause of mortality. In conclusion, MM is a peculiar type of melanoma, with clinical and molecular profile vastly different from the much-familiar CM. In the wake of the era of precision oncology, further studies on driver mutations and oncogenic pathways would likely lead to improved patient survival.

Keywords: HR; MM; OS; disease-specific survival; survival meta-analysis.

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Figures

Figure 1.
Figure 1.
Flowchart of search strategy, adopted from the PRISMA Group, 2009 (10).
Figure 2.
Figure 2.
Forest plots for advanced age. DSS, disease-specific survival; CI, confidence interval.
Figure 3.
Figure 3.
Forest plots for the lethality of mucosal melanoma vs. cutaneous melanoma (DSS). MM, mucosal melanoma; CM, cutaneous melanoma; DSS, disease-specific survival; CI, confidence interval.
Figure 4.
Figure 4.
Forest plots for TNM staging (DSS): (A) T4 vs. T3 disease, (B) N1 vs. N0 disease, and (C) M1 vs. M0 disease. DSS, disease specific survival; CI, confidence interval; TNM, tumor-node-metastasis.
Figure 4.
Figure 4.
Forest plots for TNM staging (DSS): (A) T4 vs. T3 disease, (B) N1 vs. N0 disease, and (C) M1 vs. M0 disease. DSS, disease specific survival; CI, confidence interval; TNM, tumor-node-metastasis.
Figure 4.
Figure 4.
Forest plots for TNM staging (DSS): (A) T4 vs. T3 disease, (B) N1 vs. N0 disease, and (C) M1 vs. M0 disease. DSS, disease specific survival; CI, confidence interval; TNM, tumor-node-metastasis.
Figure 5.
Figure 5.
Forest plots for adjuvant therapy (DSS): (A) Chemotherapy and (B) radiation therapy. DSS, disease-specific survival; CI, confidence interval; Adj., adjuvant.
Figure 5.
Figure 5.
Forest plots for adjuvant therapy (DSS): (A) Chemotherapy and (B) radiation therapy. DSS, disease-specific survival; CI, confidence interval; Adj., adjuvant.
Figure 6.
Figure 6.
Forest plots for immunotherapy (OS): CI, confidence interval; OS, overall survival.
See this image and copyright information in PMC

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