Fatores prognósticos do melanoma da cavidade oral: uma revisão sistemática

Abstract

Oral Melanoma (OM) is known for presents low prevalence in the world and at the same time high mortality rate. On average, 15% of patients survive more than 5 years after the treatment and the OM represents only 0.5% of all malignant neoplasms oral. Even with low incidence is observed a greater number of cases in countries like Japan, Uganda and India. The treatments described, the most recommended, is the excision of the entire lesion (with safety margins) plus the use of adjuvant therapy and, in severe cases, dissection of the regional lymph nodes. This study aims to evaluate the factors that influence the prognosis of OM, through a systematic review. Factors such as morphology, immunohistochemistry and treatment measures were evaluated and found an influence of those with prognosis of the OM. The presence of certain types of metalloproteinases (MMPs), cell type epithelioid in shape, Heparanase, Vascular Permeability Factor (VEGF) and HIF-1 were associated with a worse prognosis, as well as the absence of pigmentation lesions. The use of immunotherapy, combined with surgical treatment, and a padronization fo the treatment (preventing preoperative surgery) showed a reduced mortality rate and a decrease of the aggressivity in OM. With the discovery of new biomarkers is possible to formulate new drugs that suppress or inhibit the factors that influence to a worse prognosis, moreover, immunotherapy and a padronization of treatment are already current measurements show improvements regarding OM prognosis.