Predictors of survival in head and neck mucosal melanoma

Schmidt, Matthew Q.; David, John; Yoshida, Emi; Scher, Kevin S.; Mita, Alain C.; Shiao, Stephen L.; Ho, Allen S.; Zumsteg, Zachary S.

doi:10.1016/j.oraloncology.2017.08.002

Cited by 29 publications

(24 citation statements)

References 26 publications

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“…Due to the complex anatomical location of the paranasal sinus, paranasal sinus melanoma is found at later stages and has a wide range of invasion, so the prognosis of these patients may be poor. T stage and N stage were also independent prognostic factors, similar to the ndings of other articles [18][19][20] .…”

Section: Discussionsupporting

confidence: 87%

WITHDRAWN: Establishing and Assessing a Nomogram Based on the Clinical Features of Mucosal Melanoma of the Head and Neck

Chen

et al. 2021

Preprint

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Objectives: The rarity of mucosal melanoma of the head and neck (MMHN) and the lack of prospective clinical trials has resulted in the limited knowledge of its clinical features and prognosis. We aimed to understand the clinical characteristics and developed a nomogram to better predict the prognosis of patients with MMHN.Methods: Based on a total of 300 patients with nonmetastatic MMHN, multivariable Cox regression was performed to analyze independent prognostic factors. The overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRRFS) of MMHN patients could be monitored using the nomogram. To facilitate clinical application, an online dynamic nomogram was established.Results: Multivariate analysis identified primary tumor site, T stage and N stage as independent risk factors for survival. This factor-based nomogram had prognostic value for OS, DFS, DMFS, and LRRFS. Receiver operating characteristic analysis indicated the high diagnostic accuracy of the nomogram (AUC > 0.7). Kaplan–Meier survival curves indicated that the risk score of the nomogram effectively stratified MMHN patients with poor survival into a high-risk group (all P<0.001). Conclusions: The nomogram is conducive to stratifying MMHN patients into clinically meaningful taxonomies and subsequently providing individualized treatment.

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Section: Discussionsupporting

confidence: 87%

WITHDRAWN: Establishing and Assessing a Nomogram Based on the Clinical Features of Mucosal Melanoma of the Head and Neck

Chen

et al. 2021

Preprint

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“…A fixed effect model was used for the analysis due to a lack of heterogeneity among the studies ( I 2 = 0%). When Schmidt et al 30 was removed from the analysis, the overall survival was no longer significant 0.90 [95% CI = 0.80, 1.02] ( P = .09) (Figure 1B). The results remained unchanged when any other publication was removed from the analysis.…”

Section: Resultsmentioning

confidence: 99%

“…39 One of the strengths of this study is the number of patients that are considered and its subsequent power in the analysis of such a rare disease. One of the areas of concern in this regard is that a significant amount of the weight that is applied to the Schmidt et al 30 publication. This is a key publication in the survival analysis of HNMM and despite the fact that it carries such weight, we feel its inclusion in the analysis is just and provides an accurate picture of the treatment effect.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of radiotherapy in the treatment of head and neck mucosal melanoma: Systematic review and meta‐analysis

2020

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Introduction Mucosal melanoma (MM) is a rare condition with a poor prognosis. Surgery is the corner stone of treatment, however, radiotherapy has been commonly employed as a treatment strategy and recent studies suggesting that survival outcomes may be improving are emerging. Methods A systematic review and meta‐analysis comparing risk ratios of radiotherapy and surgery and radiotherapy (SRT) with surgery for 5‐year overall survival, local recurrence and distant metastasis in head and neck mucosal melanoma (HNMM). Results SRT has a lower risk of death compared to surgery [RR 0.93 [95% CI = 0.87, 0.98] (P = .01)] and a reduced risk of local recurrence [RR 0.63 [95% CI = 0.48, 0.82] (P = .005)]. SRT has no effect on distant metastasis. Radiotherapy has worse survival when compared to surgery [RR 1.2 [95% CI = 1.03, 1.33] (P = .0006)]. Conclusions SRT confers a moderate survival advantage in HNMM compared to surgery. This is most likely secondary to reduced local recurrence.

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“…Currently, surgery with or without postoperative radiotherapy is the widely accepted standard of care for the treatment of HNMM,10,11 However, the use of adjuvant chemotherapy (AC) has yet to be established as a method for improving treatment outcomes. Although a large multicenter retrospective study among an exclusive Caucasian population reported a 5-year survival rate of 26.7% among patients who received surgery followed by radiotherapy,12 these findings may not be generalizable in Asian populations due to both ethnic- and genetic-related differences between populations. In this study, we prospectively enrolled a predominantly Asian population with HNMM to evaluate both the efficacy and safety of primary surgery with postoperative radiotherapy ± AC in the treatment of HNMM.…”

Section: Introductionmentioning

confidence: 89%

Efficacy and safety of primary surgery with postoperative radiotherapy in head and neck mucosal melanoma: a single-arm Phase II study

Yao

Zhang

et al. 2018

CMAR

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BackgroundThere still remains no well-established treatment strategy for head and neck mucosal melanoma (HNMM). We aim to evaluate the effectiveness and safety of primary surgery with postoperative radiotherapy for this disease.Patients and methodsA single-arm, Phase II clinical trial was conducted at Sun Yat-Sen University Cancer Center. Patients with nonmetastatic, histologically proven HNMM were prospectively enrolled. Patients received primary surgery followed by intensity-modulated radiotherapy with an equivalent dose at 2 Gy per fraction of 65–70 Gy to CTV1 (high-risk regions including tumor bed) and 50–55 Gy to CTV2 (low-risk regions). Additional use of adjuvant chemotherapy (AC) depended on consultation from a multidisciplinary team. This trial is registered with ClinicalTrials.gov, number NCT03138642.ResultsA total of 33 patients were enrolled and analyzed between July 2010 and November 2016. There were 18 (54.5%) patients with T3 disease and 15 (45.5%) patients with T4a disease. The median age at diagnosis was 58 years (range 27–83 years), and 61% of the cohort were males. The overall median follow-up duration was 25.3 months (range 5.3–67.1 months). The 3-year overall survival (OS), local relapse-free survival (LRFS), regional relapse-free survival (RRFS), and distant metastasis-free survival (DMFS) rates were 44.4, 91.7, 78.1, and 41.7%, respectively. Patients with T4a disease showed significantly inferior OS (P=0.049) and DMFS (P=0.040) than those with T3 disease. Prophylactic neck radiation (PNR) was nearly associated with superior RRFS (P=0.078). However, there was no significant difference in OS, LRFS, RRFS, and DMFS for patients treated with or without AC (P>0.05 for all). Toxicities were generally mild to moderate.ConclusionPrimary surgery with postoperative radiotherapy yielded excellent local control and acceptable toxicity profile for HNMM. Nevertheless, high rates of distant metastases resulted in limited survival.

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Predictors of survival in head and neck mucosal melanoma

Cited by 29 publications

References 26 publications

WITHDRAWN: Establishing and Assessing a Nomogram Based on the Clinical Features of Mucosal Melanoma of the Head and Neck

WITHDRAWN: Establishing and Assessing a Nomogram Based on the Clinical Features of Mucosal Melanoma of the Head and Neck

The effectiveness of radiotherapy in the treatment of head and neck mucosal melanoma: Systematic review and meta‐analysis

Efficacy and safety of primary surgery with postoperative radiotherapy in head and neck mucosal melanoma: a single-arm Phase II study

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