Localized sinonasal mucosal melanoma: Outcomes and associations with stage, radiotherapy, and positron emission tomography response

Samstein, Robert M.; Carvajal, Richard D.; Postow, Michael A.; Callahan, Margaret K.; Shoushtari, Alexander N.; Patel, Snehal G.; Lee, Nancy Y.; Barker, Christopher A.

doi:10.1002/hed.24435

Cited by 75 publications

(76 citation statements)

References 52 publications

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“…The local control rate in our cohort was achieved in 62% with a median follow‐up of 23 months and was comparable to literature: Temam et al reported 46% local control (median follow‐up of 46 months), in the Moreno cohort it was 72% (median follow‐up 34 months) and both Wada et al and Samstein et al also observed 62% local control (median follow‐up 16 and 21 months, respectively).…”

Section: Discussionsupporting

confidence: 89%

“…A 25%‐45% advantage in local control was observed in the studies by Wada et al and Hardwood et al in patients treated with hypofractionated schemes compared to conventional fractionation. Contrary, the most recent studies, published by Moreno et al and Samstein et al, did not reveal any significant differences between fractionation schemes with respect to local control. However, population sizes were very limited in these 4 studies, precluding any definitive conclusions regarding the most optimal fractionation schedule.…”

Section: Introductionmentioning

confidence: 68%

“…Evidence for the addition of postoperative radiotherapy (RT) in the treatment of mucosal head and neck melanoma is based on retrospective series. To our knowledge, 9 series with at least 15 patients who underwent adjuvant RT after surgery have been published in the last 25 years . A meta‐analysis showed an average relative risk reduction of 45% for local control with the addition of postoperative RT after complete or incomplete surgical resection .…”

Section: Introductionmentioning

confidence: 99%

“…To date, there is no consensus about the optimal fractionation regime and total dose in the setting of adjuvant postoperative RT in primary sinonasal malignant melanoma . Clinical practice is mainly based on the results of 4 studies comparing different fractionation regimens . A 25%‐45% advantage in local control was observed in the studies by Wada et al and Hardwood et al in patients treated with hypofractionated schemes compared to conventional fractionation.…”

Section: Introductionmentioning

confidence: 99%

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Local control in sinonasal malignant melanoma: Comparing conventional to hypofractionated radiotherapy

et al. 2017

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Local control in sinonasal malignant melanoma: Comparing conventional to hypofractionated radiotherapy

et al. 2017

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“…[22] The overall prognosis thus remain grim and most of the patients succumb to distant metastasis in spite of achieving a clear surgical margins of resection. [23,24] CONCLUSION Mucosal melanoma of the nose and paranasal sinus are rare tumours with an adverse clinical outcome. The prognosis of these tumours have not improved significantly over the past.…”

Section: Discussionmentioning

confidence: 99%

Sinonasal Mucosal Melanoma: A Clinicopathological Review

Das¹,

Mukherjee²

2016

jemds

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Melanomas are malignant tumours, which originate from melanocytes. Melanocytes originate from the neural crest cells and then migrate to various tissues in the body during the course of development. Sinonasal melanoma are rare tumours and the aetiopathogenesis, treatment and staging of the tumours are still an area of debate. There remains paucity of studies dealing exclusively with sinonasal melanoma. We attempt to make a comprehensive study of the disease by reviewing the existing literature on sinonasal melanoma. METHODOLOGYReview of existing literature on the melanoma of nose and paranasal sinus. RESULTS AND DISCUSSIONThe melanoma of the sinonasal tract are rare and account for 1% of all melanoma. The aetiology of the tumour is still debated and the behaviour of the tumour remains conspicuously different both genetically and clinically from its cutaneous counterpart. Surgery remains the mainstay of treatment, though newer modalities are being explored. The prognosis of these tumours remain grim with a 5-year survival rate of about 25%. CONCLUSIONEarly diagnosis, histopathological confirmation and aggressive control of the primary tumour is the standard modality of treatment. The molecular biology and genetics of the tumour are an interesting field of research and targeted therapy may hold the key to improve the outcome in the future.

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Association of Surgical Approach and Margin Status With Oncologic Outcomes Following Gross Total Resection for Sinonasal Melanoma

Sayed

Migliacci

Cracchiolo

et al. 2017

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Sinonasal mucosal melanoma (SMM) is a rare malignant neoplasm characterized by a poor prognosis despite aggressive intervention including wide surgical resection. Margin status has previously been cited as an important prognostic factor for local control and overall survival (OS) in patients who undergo either an open or endoscopic surgical approach. No comparisons have been made, however, in patients who have undergone gross total resection with or without positive margins. OBJECTIVE To assess the association of margin status and surgical approach with oncologic outcomes in patients with SMM undergoing gross total resection. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, patients with SMM without evidence of regional or distant disease treated with curative intent in part or full at Memorial Sloan Kettering Cancer Center from 1998 through 2016 were retrospectively assessed. Demographic data, prognostic information, and surgical pathology were reviewed. Operative reports and imaging were used to confirm gross total resection of local disease. EXPOSURES Surgical techniques including open maxillectomy, craniofacial resection, and endoscopic resection. MAIN OUTCOMES AND MEASURES Three-year local recurrence-free survival (LRFS), disease-free survival (DFS), and OS were calculated using the Kaplan-Meier method. Univariate and multivariable analyses of outcomes were carried out using the Cox proportional hazard regression method. RESULTS Seventy-two patients (39 [54%] female; mean [SD] age, 67 [12] years) met the eligibility criteria. Thirty-eight patients (53%) underwent open partial or total maxillectomy with or without ethmoidectomy or sphenoidectomy via a transfacial approach. Fourteen patients (19%) had a more extensive craniofacial approach, and 20 patients (28%) underwent endoscopic resection. The 3-year OS for all patients was 52%. The absolute 3-year difference between patients with open/craniofacial resection vs endoscopic resection for LRFS, DFS, and OS was 11% (95% CI, −21% to 43%), 16% (95% CI, −7% to 39%), and 12% (95% CI, −18% to 41%), respectively. The absolute 3-year difference between patients with a negative margin and patients with a positive margin for LRFS, DFS, and OS was 18% (95% CI, −9% to 45%), 5% (95% CI, −17% to 27%), and 15% (95% CI, −9% to 39%), respectively. Multivariable analysis revealed that none of the adjusted variables (margin status, tumor stage, or surgical approach) were significantly associated with OS. CONCLUSIONS AND RELEVANCE Outcomes for patients with SMM remain poor regardless of operative approach or postoperative margin status.

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Localized sinonasal mucosal melanoma: Outcomes and associations with stage, radiotherapy, and positron emission tomography response

Cited by 75 publications

References 52 publications

Local control in sinonasal malignant melanoma: Comparing conventional to hypofractionated radiotherapy

Local control in sinonasal malignant melanoma: Comparing conventional to hypofractionated radiotherapy

Sinonasal Mucosal Melanoma: A Clinicopathological Review

Association of Surgical Approach and Margin Status With Oncologic Outcomes Following Gross Total Resection for Sinonasal Melanoma

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