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Patterns of Treatment Failure in Patients with Sinonasal Mucosal Melanoma

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Head and neck mucosal melanoma is a locally aggressive tumor with a high recurrence rate. The paranasal sinuses and nasal cavity are the most common primary tumor sites.

Objective

The purpose of this retrospective study was to identify independent predictors of outcome in sinonasal mucosal melanoma (SNMM) and characterize the patterns of treatment failure.

Methods

This study included 198 patients with SNMM who had been treated at The University of Texas MD Anderson Cancer Center from 1 January 1991 through 31 December 2016. The survival outcomes included overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), local recurrence-free survival, and distant metastasis-free survival. A stepwise regression analysis was used to assess associations in the multivariate models.

Results

The 5-year OS, DSS, and DFS rates were 38, 58, and 27%, respectively. Independent predictors of poor OS and DSS were the paranasal sinuses as the primary tumor site [hazard ratio (HR) 1.73, 95% confidence interval (CI) 1.11–2.66; and HR 2.12, 95% CI 1.21–3.74, respectively] and the presence of distant metastases at presentation (HR 4.53, 95% CI 2.24–7.83; and HR 3.6, 95% CI 1.12–7.1). Recurrence occurred in 96 patients (48%). The most common cause of treatment failure was distant metastasis in 69 of 198 patients (35%), followed by local [36 (18%)] and regional [22 (11%)] recurrence.

Conclusion

The most common cause of treatment failure in SNMM is distant metastasis. The tumor site and the presence of metastatic disease at presentation were the only independent predictors of survival. These data can be used to inform quality improvement efforts and the counseling of high-risk SNMM patients.

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Funding

The University of Texas MD Anderson Cancer Center is supported in part by the National Institutes of Health through Cancer Center Support Grant P30 CA016672.

Disclosures

None of the authors have a conflict of interest.

Author information

Authors and Affiliations

  1. Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Moran Amit MD, PhD, Samantha Tam MD, Ahmed S. Abdelmeguid MD, Michael E. Kupferman MD, Shirley Y. Su MBBS & Ehab Y. Hanna MD

  2. Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Shaan M. Raza MD & Franco DeMonte MD

  3. Department of Head and Neck Surgery, Division of Surgery, Unit 1445, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Ehab Y. Hanna MD

Authors
  1. Moran Amit MD, PhD
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  2. Samantha Tam MD
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  3. Ahmed S. Abdelmeguid MD
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  4. Michael E. Kupferman MD
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  5. Shirley Y. Su MBBS
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  6. Shaan M. Raza MD
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  7. Franco DeMonte MD
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  8. Ehab Y. Hanna MD
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Corresponding author

Correspondence to Ehab Y. Hanna MD.

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Supplementary material 1 (DOCX 20 kb)

10434_2018_6465_MOESM2_ESM.tiff

Supplementary material 2 (TIFF 117 kb). Electronic supplementary Fig. 1 (a) Five-year DFS; (b) LRFS; (c) RgRFS; and (d) DMFS rates, calculated using the Kaplan–Meier method (n = 198). DFS disease-free survival, LRFS local recurrence-free survival, RgRFS regional recurrence-free survival, DMFS distant metastasis-free survival

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Amit, M., Tam, S., Abdelmeguid, A.S. et al. Patterns of Treatment Failure in Patients with Sinonasal Mucosal Melanoma. Ann Surg Oncol 25, 1723–1729 (2018). https://doi.org/10.1245/s10434-018-6465-y

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  • DOI: https://doi.org/10.1245/s10434-018-6465-y

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