Impact of different surgical and postoperative adjuvant treatment modalities on survival of sinonasal malignant melanoma

BMC Cancer

Xin-Jun Meng⁴  Hua-Fei Ao¹  Wei-Ting Huang⁵  Fu Chen³  Xi-Cai Sun⁵  Jing-Jing Wang⁵  Zhuo-Fu Liu⁵  Wade W Han²  Allison N Fry²  De-Hui Wang⁵ 

[1] Department of Otolaryngology, Shanghai 3rd People’s Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai 201900, China

[2] Florida Ear Nose Throat and Facial Plastic Surgery, Orlando, Florida 32819, USA

[3] Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China

[4] Department of Otolaryngology, Ruijin Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai 200025, China

[5] Department of Otolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China

关键词: Chemotherapy;    Radiotherapy;    Endoscopic sinonasal surgery;    Prognosis;    Melanoma;    Sinonasal;   

Others  :  1134782
DOI  :  10.1186/1471-2407-14-608

 received in 2014-02-11, accepted in 2014-08-14,  发布年份 2014

【 摘 要 】

Background

The role of postoperative adjuvant treatment for sinonasal malignant melanoma remains unclear. This study evaluates the impact of three different surgical and postoperative adjuvant treatment modalities: surgery alone(open and endoscopic approaches), surgery plus radiotherapy and surgery, radiotherapy plus chemotherapy on survival of patients with primary sinonasal malignant melanoma (SMM).

Methods

The data of 69 patients who underwent primary surgical treatments at Eye & ENT hospital of Fudan University between January 1st, 2000 and December 31st, 2010 were retrospectively reviewed. Survival comparison of different surgical and postoperative adjuvant treatment modalities (surgery alone, surgery plus radiotherapy and surgery, radiotherapy plus chemotherapy), as well as survival comparison between open and endoscopic surgical approaches were performed. Curves depicting survival were performed using Kaplan-Meier method. Statistical analysis was performed using log-rank test software SPSS19 and p < .05 is considered as statistically significant.

Results

The median overall survival time was found to be 18 months for surgery alone (27 cases), 32 months for surgery plus radiotherapy (24 cases), 42 months for surgery, radiotherapy plus chemotherapy (18 cases). The 3 and 5 year survival rates for groups mentioned above were 14.8% and 5.6%, 45.1% and 31.6%, 55% and 32.1%, respectively. Statistical significances were found not only between surgery alone and surgery plus radiotherapy treatment group (P = 0.012), but also surgery alone and surgery, radiotherapy plus chemotherapy group (P = 0.002). There was no statistically significant survival difference found between the two different surgical approaches (41 cases for open approach and 28 cases for endoscopic approach).

Conclusions

Sinonasal malignant melanoma is a disease with a poor prognosis. Patients who underwent surgery plus radiotherapy or surgery, radiotherapy plus chemotherapy had better survival outcomes than those underwent surgery alone. Endoscopic approach provided similar survival outcome as an open approach.

【 授权许可】

   
2014 Meng et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】

• [1]Lund VJ, Stammberger H, Nicolai P, Castelnuovo P, Beal T, Beham A, Bernal-Sprekelsen M, Braun H, Cappabianca P, Carrau R, Cavallo L, Clarici G, Draf W, Esposito F, Fernandez-Miranda J, Fokkens W, Gardner P, Gellner V, Hellquist H, Hermann P, Hosemann W, Howard D, Jones N, Jorissen M, Kassam A, Kelly D, Kurschel-Lackner S, Leong S, McLaughlin N, Maroldi R, et al.: European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinology 2010, 2010(Suppl 22):1-143.
• [2]Tas F, Keskin S: Mucosal melanoma in the head and neck region: different clinical features and same outcome to cutaneous melanoma. ISRN Dermatol 2013, 2013:5. Artical ID:586915
• [3]Sun CZ, Li QL, Hu ZD, Jiang YE, Song M, Yang AK: Treatment and prognosis in sinonasal mucosal melanoma: A retrospective analysis of 65 patients from a single cancer center. Head Neck 2014, 36:675-681.
• [4]Jangard M, Hansson J, Ragnarsson-Olding B: Primary sinonasal malignant melanoma: a nationwide study of the Swedish population, 1960–2000. Rhinology 2013, 51:22-30.
• [5]Koivunen P, Back L, Pukkila M, Laranne J, Kinnunen I, Grenman R, Makitie AA: Accuracy of the current TNM classification in predicting survival in patients with sinonasal mucosal melanoma. Laryngoscope 2012, 122:1734-1738.
• [6]Gal TJ, Silver N, Huang B: Demographics and treatment trends in sinonasal mucosal melanoma. Laryngoscope 2011, 121:2026-2033.
• [7]Owens JM, Roberts DB, Myers JN: The role of postoperative adjuvant radiation therapy in the treatment of mucosal melanomas of the head and neck region. Arch Otolaryngol 2003, 129:864-868.
• [8]Temam S, Mamelle G, Marandas P, Wibault P, Avril MF, Janot F, Julieron M, Schwaab G, Luboinski B: Postoperative radiotherapy for primary mucosal melanoma of the head and neck. Cancer 2005, 103:313-319.
• [9]Gore MR, Zanation AM: Survival in Sinonasal Melanoma: A Meta-analysis. J Neuro Surg B 2012, 73:157-162.
• [10]Carolyn CC, Byrd DR, Garcia-Aguilar J, Kurtzman SH, Olawaiye A, Washington MK: AJCC cancer staging atlas : a companion to the seventh editions of the AJCC cancer staging manual and handbook. New York: Springer; 2012.
• [11]Suh JD, Ramakrishnan VR, Chi JJ, Palmer JN, Chiu AG: Outcomes and complications of endoscopic approaches for malignancies of the paranasal sinuses and anterior skull base. Ann Otol Rhinol Laryngol 2013, 122:54-59.
• [12]Arnold A, Ziglinas P, Ochs K, Alter N, Geretschlager A, Ladrach K, Zbaren P, Caversaccio M: Therapy options and long-term results of sinonasal malignancies. Oral Oncol 2012, 48:1031-1037.
• [13]Prasad ML, Patel SG, Huvos AG, Shah JP, Busam KJ: Primary mucosal melanoma of the head and neck: a proposal for microstaging localized, Stage I (lymph node-negative) tumors. Cancer 2004, 100:1657-1664.
• [14]Bachar G, Loh KS, O'Sullivan B, Goldstein D, Wood S, Brown D, Irish J: Mucosal melanomas of the head and neck: experience of the Princess Margaret Hospital. Head Neck 2008, 30:1325-1331.
• [15]Narasimhan K, Kucuk O, Lin HS, Heilbrun LK, Carron M, Venkatramanamoorthy R, Mathog R: Sinonasal mucosal melanoma: a 13-year experience at a single institution. Skull base 2009, 19:255-262.
• [16]Clifton N, Harrison L, Bradley PJ, Jones NS: Malignant melanoma of nasal cavity and paranasal sinuses: report of 24 patients and literature review. J Laryngol Otol 2011, 125:479-485.
• [17]Lund VJ, Chisholm EJ, Howard DJ, Wei WI: Sinonasal malignant melanoma: an analysis of 115 cases assessing outcomes of surgery, postoperative radiotherapy and endoscopic resection. Rhinology 2012, 50:203-210.
• [18]Douglas CM, Malik T, Swindell R, Lorrigan P, Slevin NJ, Homer JJ: Mucosal melanoma of the head and neck: radiotherapy or surgery? J Otolaryngol Head Neck Surg 2010, 39:385-392.
• [19]Moreno MA, Roberts DB, Kupferman ME, DeMonte F, El-Naggar AK, Williams M, Rosenthal DS, Hanna EY: Mucosal melanoma of the nose and paranasal sinuses, a contemporary experience from the M, D Anderson Cancer Center. Cancer 2010, 116:2215-2223.
• [20]Vandenhende C, Leroy X, Chevalier D, Mortuaire G: Sinonasal mucosal melanoma: retrospective survival study of 25 patients. J Laryngol Otol 2012, 126:147-151.
• [21]Enee V, Houliat T, Truilhe Y, Darrouzet V, Stoll D: [Malignant melanoma of the nasosinal mucosa. Retrospective study apropos of 20 cases]. Revue de laryngologie - otologie - rhinologie 2000, 121:243-250.
• [22]Huang SF, Liao CT, Kan CR, Chen IH: Primary mucosal melanoma of the nasal cavity and paranasal sinuses: 12 years of experience. J Otolaryngol 2007, 36:124-129.
• [23]Dauer EH, Lewis JE, Rohlinger AL, Weaver AL, Olsen KD: Sinonasal melanoma: a clinicopathologic review of 61 cases. Otolaryngol Head Neck Surg 2008, 138:347-352.
• [24]Gavriel H, McArthur G, Sizeland A, Henderson M: Review: mucosal melanoma of the head and neck. Melanoma Res 2011, 21:257-266.
• [25]Kanetaka S, Tsukuda M, Takahashi M, Komatsu M, Niho T, Horiuchi C, Matsuda H: Mucosal melanoma of the head and neck. Exp Therapeutic Med 2011, 2:907-910.
• [26]Kingdom TT, Kaplan MJ: Mucosal melanoma of the nasal cavity and paranasal sinuses. Head Neck 1995, 17:184-189.
• [27]Lund VJ, Howard DJ, Harding L, Wei WI: Management options and survival in malignant melanoma of the sinonasal mucosa. Laryngoscope 1999, 109:208-211.