Nasal and paranasal sinus mucosal melanoma: Long-term survival outcomes and prognostic factors

Am J Otolaryngol. 2021 Nov-Dec;42(6):103070. doi: 10.1016/j.amjoto.2021.103070. Epub 2021 Apr 19.

Abstract

Objective: To determine prognostic factors and survival patterns for different treatment modalities for nasal cavity (NC) and paranasal sinus (PS) mucosal melanoma (MM).

Methods: Patients from 1973 to 2013 were analyzed using the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier method and multivariable cox proportional hazard modeling were used for survival analyses.

Results: Of 928 cases of mucosal melanoma (NC = 632, PS = 302), increasing age (Hazard Ratio [HR]:1.05/year, p < 0.001), T4 tumors (HR: 1.81, p = 0.02), N1 status (HR: 6.61, p < 0.001), and PS disease (HR: 1.50, p < 0.001) were associated with worse survival. Median survival length was lower for PS versus NC (16 versus 26 months, p < 0.001). Surgery and surgery + radiation therapy (RT) improved survival over non-treatment or RT alone (p < 0.001). Adding RT to surgery did not yield a survival difference compared with surgery alone (p = 0.43). Five-year survival rates for surgery and surgery + RT were similar, at 27.7% and 25.1% (p = 0.43).

Conclusion: Surgery increased survival significantly over RT alone. RT following surgical resection did not improve survival.

Keywords: Cancer; Melanoma; Mucosal; Nasal cavity; Neoplasm; Paranasal sinus; Survival; Tumor.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Melanoma / pathology
  • Melanoma / therapy*
  • Middle Aged
  • Nasal Cavity*
  • Nasal Mucosa*
  • Neoplasm Staging
  • Nose Neoplasms / pathology
  • Nose Neoplasms / therapy*
  • Otorhinolaryngologic Surgical Procedures
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / therapy*
  • Prognosis
  • Radiotherapy / methods
  • Survival Rate
  • Time Factors
  • Treatment Outcome