Determining the epidemiologic, outcome, and prognostic factors of oral malignant melanoma by using the Surveillance, Epidemiology, and End Results database

J Am Dent Assoc. 2017 May;148(5):288-297. doi: 10.1016/j.adaj.2017.01.019. Epub 2017 Mar 18.

Abstract

Background: The authors conducted a retrospective analysis to determine the epidemiologic, outcome, and prognostic factors in patients with oral malignant melanoma (OMM).

Methods: The authors used the US National Cancer Institute's Surveillance, Epidemiology, and End Results database to analyze patients with OMM from 1973 to 2012. Study variables included age, sex, race, decade of diagnosis, extent of disease, tumor size, treatment modality, and socioeconomic status (SES).

Results: The search identified 232 patients with OMM. Overall survival (OS) and disease-specific survival (DSS) were 25% and 40%, respectively, at 5 years. Age (OS, P = .004; DSS, P = .294), surgical resection (OS, P = .046; DSS, P = .005), and extent of disease (OS, P < .001; DSS, P < .001) were independent survival determinants; tumor size was an independent predictor of OS (P = .085). For confined and locally invasive disease, surgery (OS, P = .001; DSS, P = .004) and size (OS, P = .154; DSS, P = .007) were independent determinants of OS and DSS. For metastatic disease, surgery (OS, P = .675; DSS, P = .518) was a survival determinant for both OS and DSS, whereas radiotherapy predicted improved OS (hazard ratio, 0.18; 95% confidence interval, 0.03 to 0.99; P = .049).

Conclusions: Age at diagnosis, decade of diagnosis, extent of disease, tumor size, and SES are prognostic factors related to OMM survival. Surgical resection and radiation therapy both improve OMM survival.

Practical implications: Early and detailed examinations for OMM are critical to improving the survival rate in patients with OMM, especially in older patients and patients of lower SES.

Keywords: Cancer; epidemiology; mouth neoplasms; oral and maxillofacial disease; oral cancer.

MeSH terms

  • Age Factors
  • Aged
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Melanoma / diagnosis
  • Melanoma / epidemiology*
  • Melanoma / mortality
  • Melanoma / therapy
  • Middle Aged
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / epidemiology*
  • Mouth Neoplasms / therapy
  • Prognosis
  • Racial Groups / statistics & numerical data
  • Retrospective Studies
  • SEER Program / statistics & numerical data
  • Sex Factors
  • Socioeconomic Factors
  • Survival Analysis
  • United States / epidemiology