Sinonasal melanoma: survival and prognostic implications based on site of involvement

Khan, Muhammad Zia; Kanumuri, Vivek V.; Raikundalia, Milap D.; Vázquez, Alejandro; Govindaraj, Satish; Baredes, Soly; Eloy, Jean Anderson

doi:10.1002/alr.21243

Cited by 51 publications

(47 citation statements)

References 17 publications

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“…Consistent with prior analyses, nasal cavity lesions had greater 5‐year survival and frontal sinus and overlapping lesions had the worst prognoses (Table ). There are several factors that may contribute to these findings, including available options for surgical access and other therapeutic modalities.…”

Section: Discussionsupporting

confidence: 82%

“…Survival and prognostic implications based on anatomic subsites have been previously examined for sinonasal melanoma . The authors noted that maxillary, ethmoid, and overlapping accessory sinus lesions all had statistically greater hazard's ratios and were poor prognostic indicators relative to nasal cavity for survival.…”

Section: Discussionmentioning

confidence: 99%

“…For example, access to frontal sinus lesions is certainly far more challenging, with surgical interventions potentially causing more morbidity. More importantly, due to the close proximity of critical intracranial and orbital structures, frontal sinus lesions may have already spread to these areas, following the paradigm explained by Ohngren's line . Another important consideration is that lesions arising in the nasal cavity are more likely to present earlier because patients are more likely to experience symptoms such as nasal obstruction and congestion.…”

Section: Discussionmentioning

confidence: 99%

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Sinonasal malignancies: A population‐based analysis of site‐specific incidence and survival

et al. 2015

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sinonasal malignancies: A population‐based analysis of site‐specific incidence and survival

et al. 2015

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“…The SEER database has been used to find determinants of survival in many types of head and neck cancer and has been validated in previous studies. 31–35 …”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Survival in Patients With Synovial Cell Sarcoma of the Head and Neck

Clair

Arshi

Abemayor

et al. 2016

JAMA Otolaryngol Head Neck Surg

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Importance: Synovial cell sarcoma of the head and neck (SCSHN) is a rare tumor associated with significant morbidity and mortality. The literature regarding these tumors is limited to case series and case reports. We utilized data from the population-based United States SEER cancer registry to determine factors affecting both overall survival and disease specific survival of patients with SCSHN. Objective: To determine the clinicopathologic and therapeutic factors determining survival in patients with SCSHN. Design, Setting, and Participants: The Surveillance, Epidemiology, and End Results registry was reviewed for patients with primary SCSHN from 1973–2011. Interventions: None Main Outcomes and Measures: Overall survival (OS) and disease-specific survival (DSS). Results: A total of 167 cases of SCSHN were identified. The median age at diagnosis was 37 and 59.9% of patients were males. The mono-phasic spindle cell and biphasic variants were the most common histological subtypes. Surgical resection and radiation therapy were performed in 89.8% and 64.7% of cases, respectively. The median overall survival (OS) at 2, 5, and 10 years was 77%, 66%, and 53%, respectively. Univariate Kaplan-Meier survival analysis revealed that age, race, stage, and size were associated with improved survival. Histological subtype was not associated with significant differences in survival. Radiotherapy was associated with improved disease-specific survival (p=0.003), while surgical management was not associated with improved survival. Multivariate Cox regression analysis revealed that size >5 cm (p=0.007) and stage at presentation (p=0.003) were independent determinants of OS. When separately analyzing cohorts with tumors ≤5 cm and >5 cm, stage at presentation was found to be a significant predictor of survival in both (p=0.003, p=0.010); surgical resection and radiotherapy were not associated with differential survival outcomes using this model. Conclusion and Relevance: SCSHN is an extremely rare malignancy. Independent significant determinants of survival include size >5 cm and stage at presentation. Histological subtype of the tumor is not a significant predictor of survival. Surgical resection and radiation therapy were not found to be independent determinants of survival.

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“…Recent series suggest that, specifically for mucosal melanoma of nasal cavity and paranasal sinuses, the mean survival does not exceed 40% in 28 months 12 . Depending on location, disease-specific survival at 5 years was 36.66% for those patients with nasal cavity disease, 23.80% for patients with maxillary sinus disease and 18.20% for patients with ethmoid sinus disease 43 . One large meta-analysis of patients with primary sinonasal melanoma has shown that there is no survival advantage for combined radiotherapy and surgery or chemoradiotherapy plus surgery versus surgery alone 44 .…”

Section: Discussionmentioning

confidence: 99%

Primary sinonasal mucosal melanoma – Case report and literature review

Evsei

Birceanu-Corobea

Melinte

et al. 2017

Romanian Journal of Rhinology

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BACKGROUND. Primary sinonasal mucosal melanoma is a rare tumor with a poor survival rate. There is an inherent difficulty in diagnosing these lesions, especially because their complex anatomic locations and symptoms can be frequently confused with other benign or malignant processes. The purpose of our study was to report a difficult case and review the literature and recent research on therapeutic modalities. MATERIAL AND METHODS. We herein report a 61-year-old female patient, with a history of right eye enucleation and prosthesis, who presented with obstruction of the left nostril, anterior and posterior mucopurulent rhinorrhea, anosmia, left facial numbness, left exophthalmia accompanied by ipsilateral epiphora and decreased visual acuity. RESULTS. Clinical and imagistic testing revealed a large, grayish, fleshy tumor localized in the left maxillary sinus, with extension to the left orbit (producing osteolysis of the inferior and medial orbital walls), nasopharynx, ethmoidal cells and left frontal sinus. Pathological and immunohistochemical examination confirmed the diagnosis of mucosal melanoma. Other primary sites were excluded. The patient succumbed shortly after, following only palliative treatment. CONCLUSION. Early diagnosis of primary sinonasal mucosal melanoma is essential but very difficult to detect. Any symptoms such as unilateral epistaxis or nasal obstruction in a patient over the age of 60 should be rendered suspicious. Pathological and immunohistochemical examination for diagnosis and prognostic factors are important. Although surgery is the first option for treatment, one must consider, according to tumor staging, radiotherapy and chemotherapy with immunotherapy as a viable course of treatment for advanced cases.

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Sinonasal melanoma: survival and prognostic implications based on site of involvement

Abstract: Prognosis in SNM is dependent on the anatomic subsite. Paranasal sinus involvement indicates a poorer prognosis when compared to nasal cavity disease. Patients presenting with overlapping sinus involvement have the poorest prognosis.

Cited by 51 publications

References 17 publications

Sinonasal malignancies: A population‐based analysis of site‐specific incidence and survival

Sinonasal malignancies: A population‐based analysis of site‐specific incidence and survival

Factors Associated With Survival in Patients With Synovial Cell Sarcoma of the Head and Neck

Primary sinonasal mucosal melanoma – Case report and literature review

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