Abstract:ObjectiveTo compare the effect of surgery combined with adjuvant radiotherapy and surgery alone on the prognosis of head and neck mucosal melanoma(HNMM).MethodsAn comprehensive search of the literature was performed in electronic databases (Wanfang, CNKI, MEDLINE, Cochrane Library) and a Meta analysis of acquired data that conform to the inclusion criteria was performed.ResultsA total of 11 studies were enrolled, in which 3 211 patients were included. Compared with surgery alone, surgery combined with adjuvant radiotherapy could achieve better local control （HR=0.35， 95%CI=0.24-0.50； Z=5.64， P<0.001), but couldn’t benefit the overall survival （HR=1.07， 95%CI=0.98-1.16； Z=1.43， P=0.15), and the risk of distant metastasis was not reduced （HR=2.59， 95%CI=1.20-5.61； Z=2.41， P=0.02). Subgroup analyses showed that surgery combined with adjuvant radiotherapy did not reduce the risk of death in HNMM cases （HR=1.10， 95%CI=0.86-1.43； Z=0.77， P=0.44), and that surgery plus postoperative radiotherapy had similar overall survival rate compared with surgery alone （HR=1.12， 95%CI=0.81-1.55； Z=0.70， P=0.48).ConclusionsSurgery plus adjuvant radiotherapy can achieve better local control, but not benefit survival. Highquality clinical research is still needed to explore its exact effect. However, due to the complex anatomy of the head and neck, it is still necessary to actively apply adjuvant radiotherapy to control the recurrence of local lesions, and supply it with systemic treatment in order to obtain better survival benefits.
