Table_1_Clinicopathological Features, Staging Classification, and Clinical Outcomes of Esophageal Melanoma: Evaluation of a Pooled Case Series.docx

Studies that have attempted to validate the staging systems and the predictors of survival for patients with primary malignant melanoma of the esophagus (PMME) have been underpowered given their scarcity and small scale. We aimed to review a large number of PMME cases to know more about its clinicopathological features, TNM staging systems, and survival predictors of PMME. Case reports on PMME were extracted from PubMed/Medline through bibliography search and our center. A total of 287 PMME cases were identified. The majority of the patient population was male (72.08%). The most common location of PMME was the lower esophagus (50.62%) and middle esophagus (35.39%). Among the patients, 82.28% received surgical intervention. The median overall survival (OS) duration was 15 months (0.5–244). The American Joint Commission on Cancer staging classification (AJCC) for the mucosal melanoma of the upper aerodigestive tract with stage IVB and IVC integrated in stage IVA showed better distribution of OS than that for esophageal carcinoma. T stage, N stage, and surgery had significant impacts on OS duration in univariate analysis. However, only T stage and N stage were identified as independent factors for OS duration in the multivariate Cox models. PMME is an aggressive tumor with poor prognosis. The AJCC staging system for mucosal melanoma with stage IVB and IVC integrated in stage IVA may be a better option for staging PMME patients. T stage and N stage are independent factors for OS.

针对食管原发恶性黑色素瘤（PMME）分期系统及生存预测因子进行验证的研究，由于样本稀缺且规模较小，其效力不足。本研究旨在回顾大量PMME病例，以深入了解其临床病理特征、TNM分期系统以及PMME的生存预测因子。通过PubMed/Medline的文献检索及我中心收集，共筛选出287例PMME病例。患者群体中，男性占多数（72.08%）。PMME最常见的发生部位为食管下段（50.62%）及中段（35.39%）。在患者中，82.28%接受了手术治疗。中位总生存期（OS）为15个月（范围0.5–244）。相较于食管癌，美国癌症联合委员会（AJCC）对上呼吸道黏膜黑色素瘤的分期分类（包括IVB期和IVC期纳入IVA期）在OS分布上表现更优。单因素分析显示，T分期、N分期及手术对OS有显著影响。然而，在多因素Cox模型中，仅T分期和N分期被确定为OS的独立影响因素。PMME是一种侵袭性肿瘤，预后较差。将AJCC分期系统中的IVB期和IVC期纳入IVA期，可能为PMME患者的分期提供更优选择。T分期和N分期是OS的独立影响因素。