Adjuvant radiotherapy in sinonasal mucosal melanoma: A retrospective analysis

Caspers, Coosje Jacoba Isabella; Dronkers, Emilie A. C.; Monserez, Dominiek; Wieringa, Marjan H.; Jong, Robert J. Baatenburg de; Hardillo, José A.

doi:10.1111/coa.13033

Cited by 21 publications

(34 citation statements)

References 22 publications

(70 reference statements)

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“…After title and abstract review, 1286 articles were rejected and full-texts of the remaining 36 papers were obtained and reviewed. After applying the inclusion and exclusion criteria, a total of 15 studies 3, [20][21][22][23][24][25][26][27][28][29][30][31][32][33] were included in the qualitative and quantitative synthesis ( Table 1). The reasons behind the exclusions of 21 studies are shown in Figure 1.…”

Section: Literature Search Resultsmentioning

confidence: 99%

Regional disease control in sinonasal mucosal melanoma: Systematic review and meta‐analysis

et al. 2020

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To systematically analyze the regional disease control after sinonasal mucosal melanoma (SNMM) primary treatment. Methods: The study was performed according to the PRISMA guidelines searching on Scopus, PubMed/MEDLINE, Cochrane Library, and Google Scholar databases. Results: A total of 15 studies with 936 patients (median age: 68.0 years, IQR 65-71) were included. Overall, the cumulative regional recurrence rate (RRR) was 18.4% (n = 917, 99% CI: 14.0%-23.4%), with a median follow-up of 30.0 months (n = 765, IQR 22.0-37.0). The RRR in clinical node negative patients was 17.0% (99% CI: 12.2%-22.5%), with a median follow-up of 22.0 months (n = 327, IQR 21.5-31.5). Conclusions: The RRR of SNMM after primary treatment is not to be neglected. Further prospective studies should be encouraged to clarify if elective treatment of the neck could be recommended at least in a subgroup of patients.

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Section: Literature Search Resultsmentioning

confidence: 99%

Regional disease control in sinonasal mucosal melanoma: Systematic review and meta‐analysis

et al. 2020

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“…Moreno et al found improvement of locoregional control when a total dose of more than 54 Gy was used in a standard fractionation schedule [14], which was confirmed by Yu et al and Wada et al [41,49]. Meng et al and Caspers et al found improvement of local control giving mean total dosages of 63.4 Gy and 64 Gy, respectively [34,50]. An even higher dosage above 70 Gy was suggested by Greenwalt et al to increase locoregional control [51].…”

Section: Original Articlementioning

confidence: 85%

Sinonasal mucosal melanoma: treatment strategies and survival rates for a rare disease entity

Andrianakis

Kiss

Pomberger

et al. 2021

Wien Klin Wochenschr

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Summary Background Sinonasal mucosal melanoma (SNMM) is a rare disease entity comprising 0.4–1.3% of all melanomas. Surgery with free margins has been the primary treatment over decades. Neither the addition of radiotherapy nor chemotherapy could significantly improve outcome rates of this devastating malignancy. This study presents our clinical experience with SNMM over a 19-year period and summarizes the current body of literature on SNMM. Methods This retrospective analysis included 12 patients with SNMM treated from 2001 to 2019 at an academic center. Additionally, a literature review of the last 29 years on treatment and survival data of SNMM was conducted. Results Main initial symptoms were epistaxis and nasal obstruction. Of the patients 9 underwent endoscopic surgery, 6 received adjuvant therapy. 3 patients who did not undergo surgery, received chemoradiotherapy, radiotherapy alone, and chemotherapy alone, respectively. At the time of diagnosis 2 patients had distant metastases and 4 patients developed distant metastases during the course of the disease. Mean overall survival (OS) was 30.6 months, 3‑year and 5‑year OS were 25%, and 18.2%, respectively. Conclusion Unspecific symptoms and hidden anatomic locations lead to delayed diagnosis and increased rates of metastatic dissemination. Distant metastasis is the main treatment failure in SNMM. Surgery with free margins remains the primary treatment for SNMM. Adjuvant radiotherapy might improve local control in individual cases but efficient systemic therapy is needed to improve outcome rates. To evaluate and define more effective targeted treatment options and improve outcome rates, homogeneous data and prospective multicentric analysis are needed.

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“…In the current literature, many authors explain HNMM's' high mortality with the advanced stages at the time of the diagnosis. In their opinion, complete surgical resection with negative margins is the best curative option and should be considered as the first-line treatment (1,3,5,(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

“…Absolute obtention of negative margins is still debated: when some small studies found no significant association between positive margins and local recurrence (14), larger studies such as Na'ara's", show that complete surgical resection with negative margins significantly improves the prognosis of patients with sinonasal MM (9).…”

Section: Discussionmentioning

confidence: 99%

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Mucosal Melanoma of the Head and Neck: A Retrospective Review and Current Opinion

et al. 2021

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Introduction: Head and Neck Mucosal Melanoma (HNMM) is an uncommon malignancy that arises in decreasing order in the nasal cavity, the paranasal sinuses, and the oral cavity. Although radical surgery followed by eventual radiotherapy is acknowledged as the mainstay treatment, patients with advanced stages or multi-focal tumors benefit from new systemic therapies. We wish to share our experience with these treatments and review the current literature.Materials and Methods: We present a case review of every patient treated in our center for an HNMM over the past 10 years, including every patient treated in our center for an HNMM over the past 10 years. We analyzed clinical characteristics, treatment modalities, and outcomes.Results: We included eight patients aged from 62 to 85 years old. We found six MM in the nasal cavity, one in the sphenoidal sinus, and one in the piriform sinus. Six patients underwent endoscopic surgery with negative margins, six underwent radiotherapy with variable modalities. Immunotherapy or targeted therapy was given in cases extensive tumors without the possibility of a surgical treatment or in two patient as an adjuvant treatment after R0 surgery. The three-year overall survival was 50%, and three patients (37.5%) are in remission.Conclusions: HNMM is associated with poor oncologic outcomes regarding the concerned patients of our review, as reported in the literature. New treatments such as immunotherapies or targeted therapies have not significantly changed the prognosis, but they may offer new interesting perspectives.Our small series of cases seems to confirm that surgical resection with negative margins improves overall survival.

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Adjuvant radiotherapy in sinonasal mucosal melanoma: A retrospective analysis

Abstract: Our treatment outcomes are consistent with literature. Post-operative radiotherapy seems to be associated with improved local control despite advanced disease and positive margin status in this treatment group.

Cited by 21 publications

References 22 publications

Regional disease control in sinonasal mucosal melanoma: Systematic review and meta‐analysis

Regional disease control in sinonasal mucosal melanoma: Systematic review and meta‐analysis

Sinonasal mucosal melanoma: treatment strategies and survival rates for a rare disease entity

Mucosal Melanoma of the Head and Neck: A Retrospective Review and Current Opinion

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