Moran Amit1, Samantha Tam1, Ahmed S Abdelmeguid1, Michael E Kupferman1, Shirley Y Su1, Shaan M Raza2, Franco DeMonte2, Ehab Y Hanna3,4. 1. Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 2. Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 3. Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. eyhanna@mdanderson.org. 4. Department of Head and Neck Surgery, Division of Surgery, Unit 1445, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. eyhanna@mdanderson.org.
Abstract
BACKGROUND: Head and neck mucosal melanoma is a locally aggressive tumor with a high recurrence rate. The paranasal sinuses and nasal cavity are the most common primary tumor sites. OBJECTIVE: The purpose of this retrospective study was to identify independent predictors of outcome in sinonasal mucosal melanoma (SNMM) and characterize the patterns of treatment failure. METHODS: This study included 198 patients with SNMM who had been treated at The University of Texas MD Anderson Cancer Center from 1 January 1991 through 31 December 2016. The survival outcomes included overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), local recurrence-free survival, and distant metastasis-free survival. A stepwise regression analysis was used to assess associations in the multivariate models. RESULTS: The 5-year OS, DSS, and DFS rates were 38, 58, and 27%, respectively. Independent predictors of poor OS and DSS were the paranasal sinuses as the primary tumor site [hazard ratio (HR) 1.73, 95% confidence interval (CI) 1.11-2.66; and HR 2.12, 95% CI 1.21-3.74, respectively] and the presence of distant metastases at presentation (HR 4.53, 95% CI 2.24-7.83; and HR 3.6, 95% CI 1.12-7.1). Recurrence occurred in 96 patients (48%). The most common cause of treatment failure was distant metastasis in 69 of 198 patients (35%), followed by local [36 (18%)] and regional [22 (11%)] recurrence. CONCLUSION: The most common cause of treatment failure in SNMM is distant metastasis. The tumor site and the presence of metastatic disease at presentation were the only independent predictors of survival. These data can be used to inform quality improvement efforts and the counseling of high-risk SNMM patients.
BACKGROUND: Head and neck mucosal melanoma is a locally aggressive tumor with a high recurrence rate. The paranasal sinuses and nasal cavity are the most common primary tumor sites. OBJECTIVE: The purpose of this retrospective study was to identify independent predictors of outcome in sinonasal mucosal melanoma (SNMM) and characterize the patterns of treatment failure. METHODS: This study included 198 patients with SNMM who had been treated at The University of Texas MD Anderson Cancer Center from 1 January 1991 through 31 December 2016. The survival outcomes included overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), local recurrence-free survival, and distant metastasis-free survival. A stepwise regression analysis was used to assess associations in the multivariate models. RESULTS: The 5-year OS, DSS, and DFS rates were 38, 58, and 27%, respectively. Independent predictors of poor OS and DSS were the paranasal sinuses as the primary tumor site [hazard ratio (HR) 1.73, 95% confidence interval (CI) 1.11-2.66; and HR 2.12, 95% CI 1.21-3.74, respectively] and the presence of distant metastases at presentation (HR 4.53, 95% CI 2.24-7.83; and HR 3.6, 95% CI 1.12-7.1). Recurrence occurred in 96 patients (48%). The most common cause of treatment failure was distant metastasis in 69 of 198 patients (35%), followed by local [36 (18%)] and regional [22 (11%)] recurrence. CONCLUSION: The most common cause of treatment failure in SNMM is distant metastasis. The tumor site and the presence of metastatic disease at presentation were the only independent predictors of survival. These data can be used to inform quality improvement efforts and the counseling of high-risk SNMM patients.
Authors: Christian M Meerwein; Martin Hüllner; Ralph Braun; Michael B Soyka; Grégoire B Morand; David Holzmann Journal: Eur Arch Otorhinolaryngol Date: 2019-05-16 Impact factor: 2.503
Authors: Cristina Valero; Dauren Adilbay; Conall W R Fitzgerald; Avery Yuan; Ximena Mimica; Piyush Gupta; Richard J Wong; Jatin P Shah; Snehal G Patel; Marc A Cohen; Ian Ganly Journal: Oral Oncol Date: 2021-10-21 Impact factor: 5.337
Authors: Alexander Maurer; Christian M Meerwein; Michael B Soyka; Hannes Grünig; Stephan Skawran; Urs J Mühlematter; Michael Messerli; Cäcilia E Mader; Lars Husmann; Niels J Rupp; David Holzmann; Martin W Huellner Journal: Head Neck Date: 2021-09-13 Impact factor: 3.821
Authors: Anna Hafström; Johanna Sjövall; Simon S Persson; Johan S Nilsson; Christer Svensson; Eva Brun; Lennart Greiff Journal: Eur Arch Otorhinolaryngol Date: 2021-09-12 Impact factor: 3.236
Authors: Stephanie Flukes; Shivangi Lohia; Christopher A Barker; Jennifer R Cracchiolo; Ian Ganly; Snehal G Patel; Benjamin R Roman; Jatin P Shah; Alexander N Shoushtari; Viviane Tabar; Akash Shah; Marc A Cohen Journal: Head Neck Date: 2020-08-01 Impact factor: 3.147
Authors: Stephanie Flukes; Shivangi Lohia; Christopher A Barker; Jennifer R Cracchiolo; Ian Ganly; Snehal G Patel; Benjamin R Roman; Jatin P Shah; Alexander N Shoushtari; Viviane Tabar; Marc A Cohen Journal: Oral Oncol Date: 2020-09-18 Impact factor: 5.337
Authors: Tiffany N Chao; Edward C Kuan; Charles C L Tong; Michael A Kohanski; M Sean Grady; James N Palmer; Nithin D Adappa; Bert W O'Malley Journal: J Neurol Surg B Skull Base Date: 2020-02-07
Authors: Anna Hafström; Eva Brun; Simon Persson; Johanna Sjövall; Peter Wahlberg; Lennart Greiff Journal: Laryngoscope Investig Otolaryngol Date: 2019-11-22
Authors: Christian M Meerwein; Panagiotis Balermpas; Domenic G Vital; Martina A Broglie; Michael B Soyka; David Holzmann Journal: Am J Rhinol Allergy Date: 2021-07-22 Impact factor: 2.467