Demographics and treatment trends in sinonasal mucosal melanoma

Authors

  • Thomas J. Gal MD, MPH,

    Corresponding author
    1. Division of Otolaryngology–Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, U.S.A.
    • Division of Otolaryngology, Department of Surgery, University of Kentucky Medical Center, 800 Rose St, Rm C236, Lexington, KY 40536
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  • Natalie Silver MD, MS,

    1. Division of Otolaryngology–Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, U.S.A.
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  • Bin Huang DrPH, MS

    1. Kentucky Cancer Registry, University of Kentucky, Lexington, Kentucky, U.S.A.
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To evaluate the population characteristics of mucosal melanoma of the nasal cavity and paranasal sinuses and determine the impact of the new staging classification.

Study Design:

Analysis of a national database.

Methods:

Patients were identified from the Surveillance, Epidemiology, and End Results tumor registry data with mucosal melanoma of the nasal cavity and paranasal sinuses between 2000 and 2007. Tumors were classified using the American Joint Committee on Cancer (AJCC) 6th edition site-specific staging as well as 7th edition staging for head and neck mucosal melanoma (HNMM). Incidence rates and descriptive statistics were calculated, and multivariate analysis was performed to examine the impact of demographic factors and staging on survival.

Results:

A total of 304 patients were identified. The incidence rate was 0.05 per 100,000. Fifty-six percent were female, 92% were >50 years old, and more than 90% were Caucasian; 81.6% of patients were treated with surgery, and 38.5% of patients received postoperative radiation. Overall, the 5-year survival rate was 24.2%. Significant differences in survival were observed for surgery with radiation (P = .005) and surgery alone (P = .04) compared with radiation alone. TNM staging using the AJCC 6th and 7th edition classification schemes yielded similar survival curves. However, the new classification for HNMM allows for better delineation of stage IV disease, revealing slightly improved survival for stage IVA disease.

Conclusions:

HNMM is a rare disease with a poor prognosis. Surgery remains the treatment of choice, with some role for adjuvant therapy. The new staging classification for HNMM appears to more efficiently stage this disease. Demographics and therapeutic findings are discussed.

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