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

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

Robert M Samstein  1 , Richard D Carvajal  2 , Michael A Postow  3 , Margaret K Callahan  3 , Alexander N Shoushtari  3 , Snehal G Patel  4 , Nancy Y Lee  1 , Christopher A Barker  1
Affiliations

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

Robert M Samstein et al. Head Neck. 2016 Sep.

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.

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Figures

Figure 1
Figure 1
Venn diagrams depicting number and percent of patients with local, lymph node (LN) and distant recurrence at first evidence of recurrence (A) or overall during followup. 17 patients (22%) did not recur during followup.
Figure 2
Figure 2
Kaplan-Meier survival curves depicting (A) overall survival (OS) and disease-specific survival (DSS); (B) local recurrence-free survival (LRFS) and distant recurrence-free survival (DRFS) in all patients (n=78). Time is represented in months from landmark of 12 weeks after surgery.
Figure 3
Figure 3
Kaplan-Meier curves depicting disease specific survival for patients stratified by T-stage according to the AJCC mucosal melanoma of the head and neck (MMHN) staging system. p value represents log-rank comparison.
Figure 4
Figure 4
Kaplan Meier curves depicting (A) local recurrence-free survival for patients stratified by whether patient received radiation treatment (RT); (B) disease-specific survival for patients stratified by RT. p value represents log-rank comparison.
Figure 5
Figure 5
Kaplan-Meier curves depicting disease specific survival for patients stratified by 18FDG-PET uptake (positive indicates SUV>4). p value represents log-rank comparison.
See this image and copyright information in PMC

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