Sinonasal malignant melanoma: an analysis of 115 cases assessing outcomes of surgery, postoperative radiotherapy and endoscopic resection

Abstract

Background: Melanomas account for 4% of sinonasal malignancies. We present the largest single institution series reported thus far and analyze the outcome with reference to lymph node involvement, radiotherapy and endoscopic resection. Methodology: Survival and recurrence data were analyzed on sinonasal melanoma cases collected from 1963-2010 to compare treatment strategies and to ascertain factors predicting outcome. Results: 115 cases (mean age 65.9) were treated at our institution during this period. All underwent surgical resection of the tumour, 31 (27%) endoscopically, and 51 (44%) also received radiotherapy. Five year overall survival was 28% and disease-free survival was 23.7%. Local control was achieved for a median of 21 months, 5-year disease control rate of 27.7%. Endoscopically resected cases showed a significant overall survival advantage up to 5 years. Radiotherapy did not improve local control or survival. Cervical metastases conferred a dramatically worse outcome. Conclusions: Endoscopic resection of sinonasal melanoma does not prejudice outcome. The role of radiotherapy is unproven.

Outcome for sinonasal malignancies: a population-based survey

“…Moreover, the observed 5-year OS rate of 55% for all SNMM in the present study agrees with and exceeds the OS previously reported by our group (that included a part of the present study population) [9]. The 55% OS rate also compares favourably to other studies that generally have indicated 5-year OS rates of less than 40% for SNMM [7,[10][11][12][13][14]. As discussed in our earlier publication [9], the differences might reflect our frequent utilization of neoadjuvant hyper-fractionated RT with concomitant chemotherapy or adjuvant RT following surgery for stage IVA SNMM.…”

Endoscopic Resection of Sinonasal Malignancy

“…Of 320 initial search results, 61 full‐text articles were assessed for eligibility, and 35 studies were ultimately included for systematic review and meta‐analysis 17‐52 . A total of 952 patients were included.…”

International Multicenter Study of Clinical Outcomes of Sinonasal Melanoma Shows Survival Benefit for Patients Treated with Immune Checkpoint Inhibitors and Potential Improvements to the Current TNM Staging System

“…Tumors are often detected at a late stage resulting in poor patient prognosis, with 5-year overall survival (OS) below 25%. [1][2][3] The standard of care comprises surgical resection, with comparable outcomes between open and endoscopic approaches in well-selected patients. 4,5 The efficacy of adjuvant radiotherapy and the use of systemic therapy are controversial.…”