Patterns of Treatment Failure in Patients with Sinonasal Mucosal Melanoma

  • Moran Amit
  • Samantha Tam
  • Ahmed S. Abdelmeguid
  • Michael E. Kupferman
  • Shirley Y. Su
  • Shaan M. Raza
  • Franco DeMonte
  • Ehab Y. Hanna
Head and Neck Oncology
  • 44 Downloads

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.

Notes

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.

Supplementary material

10434_2018_6465_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 kb)
10434_2018_6465_MOESM2_ESM.tiff (118 kb)
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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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Moran Amit
    • 1
  • Samantha Tam
    • 1
  • Ahmed S. Abdelmeguid
    • 1
  • Michael E. Kupferman
    • 1
  • Shirley Y. Su
    • 1
  • Shaan M. Raza
    • 2
  • Franco DeMonte
    • 2
  • Ehab Y. Hanna
    • 1
    • 3
  1. 1.Department of Head and Neck Surgery, Division of SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Neurosurgery, Division of SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA
  3. 3.Department of Head and Neck Surgery, Division of Surgery, Unit 1445The University of Texas MD Anderson Cancer CenterHoustonUSA

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