A retrospective study of patients with head and neck mucosal melanoma (HNMM) showed a 5-year overall survival (OS) rate of 49.4% for those undergoing surgery. The findings from this study were reported in the European Journal of Cancer.
The 2 subtypes of mucosal melanoma, sinonasal mucosal melanoma and oral cavity mucosal melanoma, have been associated with aggressive disease and poor clinical outcomes. Nevertheless, the rarity of these cancers, estimated to comprise only 1% to 4% of all melanomas, has limited investigations of patients with HNMM.
This study utilized prospectively collected data included in the French Rare Head and Neck Cancer Expert Network (REFCOR) national database between 2000 and 2017 to evaluate the oncologic outcomes of patients with HNMM. Secondary study objectives included the identification of prognostic factors, as well as an assessment of the clinical impact of postoperative radiation therapy, for patients with the 2 subtypes of HNMM.
A total of 314 patients were included in the study; mean age was 66.6 years; and the site of primary tumor was the nasal fossa, the sinuses, and the oral cavity in 58.2%, 14.5%, and 14.3% of patients, respectively.
The diagnosis for the majority of patients in the overall HNMM cohort was T3 (69.3%), N0 (83.4%), M0 (87.4%) disease, although the rate of nodal metastases at diagnosis differed significantly between those with sinonasal mucosal melanoma (9.5%) and oral cavity mucosal melanoma (35%; P <.0001). Also noted was a higher percentage of M1 disease in patients with oral cavity mucosal melanoma (19.5%) compared with those who had sinonasal mucosal melanoma (9.5%), although this difference was not statistically significant (P =.098).
Approximately three-quarters of patients with M0 disease underwent surgery, with negative surgical margins achieved in 70.3% of patients with sinonasal mucosal melanoma and 60.9% of patients with oral cavity mucosal melanoma. Surgery plus postoperative radiation therapy was administered to 53.8% and 40.9% of those with sinonasal mucosal melanoma and oral cavity mucosal melanoma, respectively.
At a median follow-up of 45.5 months, median OS for the overall HNMM cohort was 49.0 months, 16.7 months, and 8.3 months for those with M0 disease undergoing surgery, M0 disease not undergoing surgery, and M1 disease, respectively.