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Published on: May 18, 2018
Nasal and paranasal sinus mucosal melanoma: Long-term survival outcomes and prognostic factors
Nicholas B Abt1, Lauren E Miller1, Tara E Mokhtari1
1Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
Objective:
To determine prognostic factors and survival patterns for different treatment modalities for nasal cavity (NC) and paranasal sinus (PS) mucosal melanoma (MM).
Methods:
Patients from 1973 to 2013 were analyzed using the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier method and multivariable cox proportional hazard modeling were used for survival analyses.
Results:
Of 928 cases of mucosal melanoma (NC = 632, PS = 302), increasing age (Hazard Ratio [HR]:1.05/year, p < 0.001), T4 tumors (HR: 1.81, p = 0.02), N1 status (HR: 6.61, p < 0.001), and PS disease (HR: 1.50, p < 0.001) were associated with worse survival. Median survival length was lower for PS versus NC (16 versus 26 months, p < 0.001). Surgery and surgery + radiation therapy (RT) improved survival over non-treatment or RT alone (p < 0.001). Adding RT to surgery did not yield a survival difference compared with surgery alone (p = 0.43). Five-year survival rates for surgery and surgery + RT were similar, at 27.7% and 25.1% (p = 0.43).
Conclusion:
Surgery increased survival significantly over RT alone. RT following surgical resection did not improve survival.
Insights
Surgery significantly improves survival for mucosal melanoma patients compared to radiation therapy alone. Adding radiation therapy to surgery does not further enhance survival outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- Mucosal melanoma (MM) of the nasal cavity (NC) and paranasal sinus (PS) is a rare and aggressive malignancy.
- Understanding prognostic factors and optimal treatment strategies is crucial for improving patient outcomes.
Purpose of the Study:
- To identify prognostic factors influencing survival in NC and PS MM.
- To compare survival patterns across different treatment modalities, including surgery and radiation therapy (RT).
Main Methods:
- Analysis of 928 NC and PS MM cases from the Surveillance, Epidemiology, and End Results (SEER) database (1973-2013).
- Kaplan-Meier method and multivariable Cox proportional hazard modeling were employed for survival analysis.
Main Results:
- Increasing age, T4 tumors, N1 status, and PS disease were associated with worse survival.
- Surgery and combined surgery + RT significantly improved survival compared to no treatment or RT alone.
- No significant survival difference was observed between surgery alone and surgery + RT (p=0.43).
Conclusions:
- Surgery is a superior treatment modality for NC and PS MM compared to RT alone.
- Adjuvant RT following surgical resection does not confer additional survival benefits.
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