Abstract
Mucosal melanoma of oral cavity (MMO) is a relatively rare tumour comprising of 40% of all head and neck mucosal melanomas. This study assessed the treatment outcomes and factors affecting prognosis in oral cavity mucosal melanomas. The clinical case records of 25 cases of oral cavity mucosal melanomas treated in our institution during 2003–2013 were retrospectively reviewed. Various clinicopathological parameters were taken into consideration and statistical analysis done by Kaplan–Meier method and Cox’s proportional hazards model. The most common sites of MMO were upper alveolus and hard palate (64%) followed by lower alveolus (28%). 57.1% mucosal melanomas of hard palate and upper alveolus had associated metastatic lymph nodes whereas all cases of MMO of lower alveolus had lymph node metastasis. Disease failure at distant sites was higher than that at primary site or lymph nodes. The most common site of distant metastases was brain. The 5-year OS for treated cases was 23.8% and among subsites, MMO of hard palate and upper alveolus had the highest survival. Metastasis to lymph nodes and bone infiltration by tumour significantly decreased the survival. Recurrence at primary site had the worst prognosis. MMO with lymph nodal involvement and bone erosion had poor prognosis. Due to high chances of lymph node metastases and disease recurrence in lymph nodes following treatment, it is essential to do an elective neck dissection for all cases of MMO. Disease failure at primary site was an independent predictor of outcome in MMO.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Abbreviations
- MMO:
-
Mucosal melanoma of oral cavity
- CT:
-
Computed tomography
- MRI:
-
Magnetic resonance imaging
- PET:
-
Positron emission tomography
- FDG:
-
Fluorodeoxy glucose
- OS:
-
Overall survival
- DSS:
-
Disease specific survival
- AJCC:
-
American Joint Committee on Cancer
- NCCN:
-
National Comprehensive Cancer Network
References
Carvajal RD, Spencer SA, Lydiatt W (2012) Mucosal melanoma: a clinically and biologically unique disease entity. J Natl Comp Cancer Netw 10(3):345–356
Patel SG, Prasad ML, Escrig M et al (2002) Primary mucosal malignant melanoma of the head and neck. Head Neck 24:247–257
Nandapalan V, Roland NJ, Helliwell TR et al (1998) Mucosal melanoma of the head and neck. Clin Otolaryngol Allied Sci 23:107–116
Chaudhry AP, Hampel A, Gorlin RJ (1958) Primary malignant melanoma of the oral cavity. Cancer 11:923–928
Umeda M, Shimada K (1994) Primary malignant melanoma of the oral cavity—its histological classification and treatment. Br J Oral Maxillofac Surg 32:39–47
O ’Regan K, Breen M, Ramaiya N et al (2013) Metastatic mucosal melanoma: imaging patterns of metastasis and recurrence. Cancer Imaging 13(4):626–632
Medina JE, Ferlito A, Pellitteri PK et al (2003) Current management of mucosal melanoma of the head and neck. J Surg Oncol 83:116–122
Krengli M, Masini L, Kaanders JH et al (2006) Radiotherapy in the treatment of mucosal melanoma of the upper aerodigestive tract: analysis of 74 cases. A rare cancer network study. Int J Radiat Oncol Biol Phys 65:751–759
NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. National Comprehensive Cancer Network. Version 2.2017, May 8, 2017
Mendenhall WM, Amdur RJ, Hinerman RW et al (2005) Head and neck mucosal melanoma. Am J Clin Oncol 28(6):626–630
Bartell HL, Bedikian AY, Papadopoulos NE et al (2008) Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck 30:1592–1598
Ives NJ, Stowe RL, Lorigan P et al (2007) Chemotherapy compared with biochemotherapy for the treatment of metastatic melanoma: a meta-analysis of 18 trials involving 2,621 patients. J Clin Oncol 25:5426–5434
Bajetta E, Del Vecchio M, Nova P et al (2006) Multicenter phase III randomized trial of polychemotherapy (CVD regimen) versus the same chemotherapy (CT) plus subcutaneous interleukin-2 and interferon-alpha2b in metastatic melanoma. Ann Oncol 17:571–577
Valsecchi ME, Sato T (2013) The potential role of sunitinib targeting melanomas. Expert Opin Investig Drugs 22:1473–1483
Carvajal RD, Antonescu CR, Wolchok JD et al (2011) KIT as a therapeutic target in metastatic melanoma. JAMA 305:2327–2334
Benlyazid A, Thariat J, Temam S et al (2010) Postoperative radiotherapy in head and neck mucosal melanoma: a GETTEC study. Arch Otolaryngol Head Neck Surg 136(12):1219–1225
Wu AJ, Gomez J, Zhung JE et al (2010) Radiotherapy after surgical resection for head and neck mucosal melanoma. Am J Clin Oncol 33(3):281–285
Acknowledgements
We take this opportunity to thank the fellows, post graduates and staff of the department of Head & Neck Surgery for their whole-hearted cooperation in completion of this study. We also express our gratitude to the staff of Medical Records department for providing us case records to acquire data for this study.
Funding
There was no funding for this research work.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The author declare that there are no conflicts of interest in this research study.
Ethical Approval
All procedures performed in studies were in accordance with the ethical standards of Regional Cancer Centre, Thiruvananthapuram approved by the Institutional Ethics Committee.
Informed Consent
The author agrees to publish this article.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Janardhan, D., George, N.A., Suresh, S. et al. Mucosal Melanomas of the Oral Cavity: A Tertiary Care Centre Experience of Surgically Treated Cases. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 2099–2103 (2022). https://doi.org/10.1007/s12070-020-01962-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-020-01962-2