David Jarrom1, Vinidh Paleri2,3, Cyrus Kerawala4, Thomas Roques5, Shreerang Bhide6, Laurence Newman7, Stuart C Winter8. 1. National Collaborating Centre for Cancer, Park House, Cardiff, United Kingdom. 2. Department of Otolaryngology - Head and Neck Surgery, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, United Kingdom. 3. Department of Head and Neck Surgery, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom. 4. Department of Maxillofacial / Head and Neck Surgery, The Royal Marsden Hospital, Greater London, United Kingdom. 5. Department of Clinical Oncology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom. 6. Department of Clinical Oncology, The Royal Marsden Hospital NHS Foundation Trust, Sutton, Surrey, United Kingdom. 7. Department of Maxillofacial / Head and Neck Surgery, The Queen Victoria Hospital NHS Foundation Trust, East Grinstead, West Sussex, United Kingdom. 8. Department of ENT Surgery, Oxford University NHS Trusts, Oxford, United Kingdom.
Abstract
BACKGROUND: Mucosal melanoma of the upper aerodigestive tract (MM-UADT) occurs in a complex anatomic region. It represents a small number of tumors of the head and neck and a small number of melanoma cases. METHODS: Search strategies initially identified 600, 11 of which were included in this study. RESULTS: All studies involved surgery and radiotherapy. None were randomized, and all were assessed as having a high risk of selection and performance bias. No studies reported quality of life, treatment-related mortality, or morbidity. The results indicate that the addition of radiotherapy to surgery reduces the rate of locoregional recurrence (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.42-0.87). There was no statistically significant difference in overall survival (HR, 1.16; 95% CI, 0.98-1.37). CONCLUSION: Surgical resection with postoperative radiotherapy remains the optimal treatment strategy for locoregional control. More robust studies and the use of molecular targeted therapies need to be undertaken to improve overall survival.
BACKGROUND:Mucosal melanoma of the upper aerodigestive tract (MM-UADT) occurs in a complex anatomic region. It represents a small number of tumors of the head and neck and a small number of melanoma cases. METHODS: Search strategies initially identified 600, 11 of which were included in this study. RESULTS: All studies involved surgery and radiotherapy. None were randomized, and all were assessed as having a high risk of selection and performance bias. No studies reported quality of life, treatment-related mortality, or morbidity. The results indicate that the addition of radiotherapy to surgery reduces the rate of locoregional recurrence (hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.42-0.87). There was no statistically significant difference in overall survival (HR, 1.16; 95% CI, 0.98-1.37). CONCLUSION: Surgical resection with postoperative radiotherapy remains the optimal treatment strategy for locoregional control. More robust studies and the use of molecular targeted therapies need to be undertaken to improve overall survival.
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