Background/Objectives: SNMM is a rare and aggressive malignancy with a poor prognosis. The current staging systems fail to adequately stratify patient risk. This study aimed to evaluate the prognostic impact of tumor location and extension on overall survival (OS) in SNMM. Methods: A systematic literature search of Medline, Web of Science, and Embase was performed to identify studies assessing the prognostic significance of tumor location and extension. Study quality was evaluated using the Quality in Prognosis Studies (QUIPS-2) tool. Meta-analyses were conducted to calculate pooled hazard ratios (HRs) with 95% confidence intervals (CIs). Eligible studies included primary SNMM reporting tumor location/extension and survival; observational designs (case series ≥ 5 patients) were eligible with no language restrictions. Searches covered MEDLINE, Web of Science, and Embase and were last updated on 10 Jan 2025; reference lists were also screened. Results: Thirty-four studies were included in the systematic review, of which ten met criteria for meta-analysis. Tumors located in the paranasal sinuses (HR = 2.89, 95% CI: 1.63–5.14) and those with orbital involvement (HR = 1.92, 95% CI: 1.34–2.73) were associated with significantly poorer OS. Maxillary and ethmoid sinus involvement showed no statistically significant difference compared with nasal cavity tumors. Conclusions: Tumor location and extension are significant prognostic indicators in SNMM. Patients with paranasal sinus tumors or orbital invasion have worse outcomes, supporting inclusion of these factors in future staging systems for better clinical decision-making. Limitations include the observational nature of the evidence, heterogeneity across definitions and analyses, and underpowered publication-bias tests; certainty of evidence was not formally graded.
**背景/目的：** 鼻腔鼻窦黏膜黑色素瘤是一种罕见且侵袭性强的恶性肿瘤，预后不良。现有的分期系统未能充分对患者风险进行分层。本研究旨在评估肿瘤位置和侵犯范围对SNMM患者总生存期的预后影响。 **方法：** 对Medline、Web of Science和Embase数据库进行了系统性文献检索，以识别评估肿瘤位置和侵犯范围预后意义的研究。研究质量使用预后研究质量评估工具进行评价。进行荟萃分析以计算汇总风险比及其95%置信区间。符合条件的研究包括报告肿瘤位置/侵犯范围和生存情况的原发性SNMM研究；观察性设计（病例系列≥5例患者）符合条件，无语言限制。检索覆盖MEDLINE、Web of Science和Embase数据库，最后更新日期为2025年1月10日；同时筛选了参考文献列表。 **结果：** 系统综述共纳入34项研究，其中10项符合荟萃分析标准。位于鼻旁窦的肿瘤和伴有眼眶侵犯的肿瘤与显著较差的总生存期相关。与鼻腔肿瘤相比，上颌窦和筛窦受累未显示出统计学上的显著差异。 **结论：** 肿瘤位置和侵犯范围是SNMM重要的预后指标。患有鼻旁窦肿瘤或眼眶侵犯的患者预后更差，这支持将这些因素纳入未来的分期系统，以利于更好的临床决策。局限性包括证据的观察性性质、定义和分析方法间的异质性、检验效能不足的发表偏倚检验；未对证据的确定性进行正式分级。
肿瘤(癌症)患者之家