Mucosal melanoma of the head and neck

Outcomes after radiotherapy for head and neck mucosal melanoma (MMHN).

From 1974 to 2005, 17 patients with primary MMHN were treated with radiotherapy. Primary sites included nasal cavity, paranasal sinuses, and oral cavity or oropharynx. Thirteen patients received surgery and postoperative radiotherapy; 4 received definitive radiotherapy.

Local control was 79% at 1 and 5 years for 13 of 13 patients treated with surgery and postoperative radiotherapy compared with 1 of 4 patients treated with definitive radiotherapy. Three patients recurred in the neck; 13 patients developed distant metastases. Disease-free survival was 23% at 1 year and 18% at 5 years. Absolute and cause-specific survivals were identical (53% and 28% at 1 and 5 years).

Locoregional control is relatively high after surgery and adjuvant radiotherapy, but most patients recur in distant sites; approximately one fourth of patients are cured at 5 years. Patients with unresectable tumor may be controlled with definitive radiotherapy.