Author/Editor     Plavc, Gaber; But Hadžić, Jasna; Aničin, Aleksandar; Lanišnik, Boštjan; Didanovič, Vojislav; Strojan, Primož
Title     Mucosal melanoma of the head and neck
Type     članek
Vol. and No.     Letnik 11, št. 1
Publication year     2016
ISSN     1748-717X - Radiation oncology (London, England)
Language     eng
Abstract     OBJECTIVES: To assess the incidence and to review experience with the treatment of mucosal melanoma of the head and neck (MMHN) in Slovenia between 1985 and 2013. METHODS: The National Cancer Registry database and clinical records with outcome data of identified patients treated during the period 1985-2013 in Slovenia were reviewed. RESULTS: In a 29-year period, 61 patients with MMHN were identified, representing 0.5 % of all head and neck malignant tumors and 42 % of all mucosal melanomas in Slovenia. 72 % originated in the sinonasal tract and were predominantly (78 %) diagnosed as a local disease. Regional metastases at diagnosis were more frequent in patients with oral/oropharyngeal primary (44 %; sinonasal MMHN 11 %, p%=%0.006). Curative intent treatment was given to 48 (79 %) patients. The overall survival (OS) rates at 2 and 5 years for the whole cohort were 43 % and 18 %, respectively, and for the curative intent group 53 % and 24 %, respectively. In the latter group, multivariate analyses showed postoperative radiotherapy (PORT) to be predictive for locoregional control (LRC) (hazard ratios [HR] for surgery with PORT vs. surgery alone: 1.0 vs. 3.9, p%=%0.037), whereas only the World Health Organization performance status (HR for grade 0 vs. grade 1 vs. grade >1: 1.0 (p%=%0.022) vs. 1.2 (p%=%0.640) vs. 7.7 (p%=%0.008)) significantly influenced OS. CONCLUSIONS: MMHN is a rare tumor with a poor prognosis. Combination of surgery and PORT offers the best prospects for LRC but without improvement of OS. Due to potential toxicity of high-dose RT such treatment is indicated in patients in whom LRC outweighs the risks of serious adverse effects.
Keywords     sluznični melanom
rak glave in vratu
epidemiologija
zdravljenje
preživetje
mucosal melanoma
head and neck cancer
epidemiology
therapy
survival