Localized sinonasal mucosal melanoma: Outcomes and associations with stage, radiotherapy, and positron emission tomography response

Head Neck. 2016 Sep;38(9):1310-7. doi: 10.1002/hed.24435. Epub 2016 Apr 4.

Abstract

Background: Sinonasal mucosal melanoma is a rare neoplasm with a poor prognosis.

Methods: Retrospective analysis was conducted on 78 patients with localized sinonasal mucosal melanoma treated at Memorial Sloan Kettering Cancer Center (MSKCC from 1998-2013). Demographic, tumor, imaging, and treatment factors were recorded and survival and disease-control outcomes were analyzed.

Results: Median overall survival (OS) and disease-specific survival (DSS) were 32 and 50 months, respectively. Median locoregional recurrence-free survival (LRFS) and distant recurrence-free survival (DRFS) were 43 and 12 months, respectively. Multivariate analysis demonstrated greater OS in nasal cavity tumors and earlier T classification. Radiotherapy (RT) was associated with significantly greater LRFS (5-years; 35% vs 59%; p = .01), but no difference in OS. Post-RT positron emission tomography (PET) response was associated with greater OS.

Conclusion: Distant metastasis is the predominant mode of recurrence in sinonasal mucosal melanoma, but local recurrence remains common. RT is associated with improved local control, but no survival benefit. The prognostic value of post-RT PET imaging warrants further investigation. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1310-1317, 2016.

Keywords: mucosal melanoma; nasal cavity; paranasal sinus; positron emission tomography; radiotherapy; sinonasal.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Cohort Studies
  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Melanoma / diagnostic imaging
  • Melanoma / mortality
  • Melanoma / pathology*
  • Melanoma / therapy*
  • Middle Aged
  • Multivariate Analysis
  • Nasal Mucosa / pathology*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Paranasal Sinus Neoplasms / diagnostic imaging
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / pathology*
  • Paranasal Sinus Neoplasms / therapy*
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Proportional Hazards Models
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome