Omar Breik1, Felix Sim2, Tim Wong3, Alf Nastri4, Tim A Iseli5, David Wiesenfeld6. 1. Registrar, Department of Oral and Maxillofacial Surgery, Head and Neck Oncology Tumour Stream, Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia. Electronic address: Omar.breik@gmail.com. 2. Head and Neck Fellow, Head and Neck Tumour Stream, Head and Neck Oncology Tumour Stream, Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia. 3. Consultant Oral and Maxillofacial Surgeon, Head and Neck Oncology Tumour Stream, Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia. 4. Head of Unit, Department of Oral and Maxillofacial Surgery, Head and Neck Oncology Tumour Stream, Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia. 5. Head of Unit, Department of Otorhinolaryngology, Head and Neck Oncology Tumour Stream, Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia. 6. Head, Head and Neck Tumour Stream, Head and Neck Oncology Tumour Stream, Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Abstract
PURPOSE: Malignant mucosal melanoma of the head and neck (MMHN) is an aggressive and rare neoplasm with poor long-term outcomes. The aim of this study is to evaluate the outcomes of patients treated by a single-institution head and neck multidisciplinary team. MATERIALS AND METHODS: In this retrospective case series, all MMHN cases treated at the Royal Melbourne Hospital from 1990-2015 were retrospectively reviewed. Patient demographic characteristics (eg, age), treatment offered, pathology, and outcomes were collected, tabulated, and correlated with outcomes. Survival outcomes were calculated by the Kaplan-Meier method. Comparison was made between oral and sinonasal melanomas. RESULTS: A total of 16 cases were identified. Two were excluded because of inaccessible data. Of the 14 remaining cases, 8 were sinonasal melanomas and 6 were oral cavity melanomas. Sinonasal tumor patients presented with epistaxis or visual impairment. Oral melanoma patients presented with pigmented lesions or ulceration. Follow-up ranged from 4 months to 11 years. In 2 patients, locoregional recurrences developed that were successfully re-excised. Six patients died of distant metastases despite clear surgical margins. Two patients with sinonasal melanomas died of extensive local disease with intracranial invasion. One patient died 4 years after diagnosis without disease. There were no failures in the neck. The 2- and 5-year overall survival rates were 63.3% and 31.7%, respectively, by the Kaplan-Meier method. The difference in survival between oral and sinonasal melanomas was not statistically significant. CONCLUSIONS: Despite clear surgical margins, MMHN has a poor prognosis and most deaths are due to distant metastases. Systemic therapies such as those used in cutaneous melanoma treatment might be used in the future for MMHN.
PURPOSE:Malignant mucosal melanoma of the head and neck (MMHN) is an aggressive and rare neoplasm with poor long-term outcomes. The aim of this study is to evaluate the outcomes of patients treated by a single-institution head and neck multidisciplinary team. MATERIALS AND METHODS: In this retrospective case series, all MMHN cases treated at the Royal Melbourne Hospital from 1990-2015 were retrospectively reviewed. Patient demographic characteristics (eg, age), treatment offered, pathology, and outcomes were collected, tabulated, and correlated with outcomes. Survival outcomes were calculated by the Kaplan-Meier method. Comparison was made between oral and sinonasal melanomas. RESULTS: A total of 16 cases were identified. Two were excluded because of inaccessible data. Of the 14 remaining cases, 8 were sinonasal melanomas and 6 were oral cavity melanomas. Sinonasal tumorpatients presented with epistaxis or visual impairment. Oral melanomapatients presented with pigmented lesions or ulceration. Follow-up ranged from 4 months to 11 years. In 2 patients, locoregional recurrences developed that were successfully re-excised. Six patients died of distant metastases despite clear surgical margins. Two patients with sinonasal melanomas died of extensive local disease with intracranial invasion. One patient died 4 years after diagnosis without disease. There were no failures in the neck. The 2- and 5-year overall survival rates were 63.3% and 31.7%, respectively, by the Kaplan-Meier method. The difference in survival between oral and sinonasal melanomas was not statistically significant. CONCLUSIONS: Despite clear surgical margins, MMHN has a poor prognosis and most deaths are due to distant metastases. Systemic therapies such as those used in cutaneous melanoma treatment might be used in the future for MMHN.
Authors: Beata Sas-Korczynska; Marian Reinfuss; Jerzy W Mitus; Elzbieta Pluta; Anna Patla; Tomasz Walasek Journal: Rep Pract Oncol Radiother Date: 2018-08-17