Because of the poor prognosis and of oral mucosal
melanoma, and patients' short survival, large, randomised, clinical studies are difficult. We have investigated its demographic characteristics and analysed the effect of treatment,
resection margins, and
metastases on survival. We recorded age, sex, site of primary tumour, and types of treatment, survival, and
metastases in 74 patients treated at the Department of Oral and
Maxillofacial Surgery, Seoul National University Dental Hospital. Survival was analysed based on bony invasion, depth of invasion, and
resection margins, and we found that it varied depending on the primary site (p=0.002), and declined with liver (p=0.001) or brain (p=0.033)
metastases. The two-year survival according to the primary site was as follows: palate 85% (n=32), anterior maxillary gingiva 53% (n=13), mandible 58% (n=13), and posterior maxillary gingival 74% (n=10) and buccal mucosa 50% (n=4). The two-year survival was 34% (n=8) in patients with liver
metastases and 23% (n=7) in patients with
brain metastases. In cases of bony invasion (p=0.005), depth of invasion (p=0.042), unclear
resection margin (p=0.023), or higher T stages (p=0.009), the survival declined considerably.
Neck dissection did not affect survival (p=0.343). Survival of the patients given
chemotherapy was significantly lower (p=0.013) and the two-year survival was 54.0%. The patients given
radiotherapy showed no significant difference in survival compared with those not given
radiotherapy (p=0.107). In conclusion, primary site, bony invasion,
resection margins, depth of invasion and systemic
metastases were critical to predict prognosis and selection of treatment of oral mucosal
melanoma.