What is the role of the surgeon in the management of head and neck mucosal melanoma in the immunotherapy era?

Edmond, Mark; Nenclares, Pablo; Harrington, Kevin; Dafydd, Derfel Ap; Bagwan, Izhar; Begg, Donna; Lingley, Ken; Patterson, Gillian; Payne, Miranda; Steven, Neil; Turnbull, Nancy; Yip, Kent; Silva, Priyamal; Kerawala, Cyrus; Paleri, Vinidh; King, Emma V.

doi:10.1002/hed.26849

Cited by 7 publications

(7 citation statements)

References 28 publications

(61 reference statements)

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“…It has an aggressive course with poor prognosis and subsequent metastasis even with a surgical approach. There are currently no established guidelines on treatment modalities for mucosal melanomas occurring in the gastrointestinal tract unlike other mucosal melanomas[ 26 , 27 ]. Most published literature on gastrointestinal mucosal melanomas are from case reports and case series[ 2 , 28 – 35 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and outcomes of gastrointestinal mucosal melanomas: a national database analysis

et al. 2022

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Aim Gastrointestinal malignant melanoma is a rare mucosal melanoma (MM). Other MM include the respiratory and the genitourinary tract. All mucosal melanomas have a poor prognosis when compared to cutaneous melanomas. Ano-rectal melanomas are by far the most common and most studied gastrointestinal MM. Large-scale clinical data is lacking due to the rarity of the disease. We aim to analyze epidemiology and survival of the Gastrointestinal (G.I.) MM over 45 years using a national database. Methods The Surveillance, Epidemiology and End Results (SEER) database was queried to identify patients with biopsy-proven G.I. Melanomas. We selected tumor site, intervention, and survival information for oncology codes as per the international classification of diseases. Survival analysis was performed using the SPSS v 27 ® IBM software. Results Of the 1105 biopsy-proven confirmed cases of primary G.I. melanoma's, 191 (17.3%) received chemotherapy (C.T.), 202 (18.3%) received radiotherapy (R.T.), 63 (5.7%) received both C.T and R.T., while 684 (61.9%) of the population received surgery alone or combined with C.T. and/or R.T. Statistically significant improvement in survival was noted in all treatment strategies that utilized surgery and also when site-specific MM cohorts underwent a surgical approach with or without C.T and/or R.T. Conclusion This is the most extensive study reporting epidemiological and survival data of treatment strategy outcomes of primary G.I. mucosal melanoma elucidating best overall survival with a management strategy involving surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and outcomes of gastrointestinal mucosal melanomas: a national database analysis

et al. 2022

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“…Following the treatment paradigm of cutaneous melanoma as well as the majority of SNM, surgical resection remains the primary treatment modality for SNMM tumors that are resectable (Table XXIV.D.1). 269,278,366,1483,1499–1501 Complete tumor resection with negative margins is the goal of surgical intervention, including resection of all skip lesions when present 1499,1501 …”

Section: Sinonasal Neuroectodermal and Neuroendocrine Carcinomasmentioning

confidence: 99%

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

Kuan

Wang

Adappa

et al. 2024

Int Forum Allergy Rhinol

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BackgroundSinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represents a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology‐based topics spanning the field.MethodsIn accordance with prior ICAR documents, ICSNT assigned each topic as an Evidence‐Based Review with Recommendations, Evidence‐Based Review, and Literature Review based on level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses format, and completed sections underwent a thorough and iterative consensus‐building process. The final document underwent rigorous synthesis and review prior to publication.ResultsThe ICNST document consists of 4 major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology‐based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention.ConclusionAs an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.This article is protected by copyright. All rights reserved

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“…The follow-up schedule in the UK national guidelines for patients after potentially curative treatment or treatment for relapse is summarised in Table C [1,4,13]. The imaging described in the table should include postcontrast CT of the neck, chest, abdomen and pelvis to identify local and systemic disease and ideally post-contrast MRI of the brain to identify intracranial metastatic disease.…”

Section: Follow-up Imaging Primary Treatmentmentioning

confidence: 99%

“…These tumours most commonly arise in the nasal cavity and paranasal sinuses (approximately 80%) with around 15% of cases arising in the oral cavity. Tumours arising from the pharynx and larynx are much less common [4,5]. Clinical presentation of HNMM is variable, naturally depending on the location of the primary tumour, with epistaxis and nasal obstruction being the most common presenting symptoms overall [6].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical presentation of HNMM is variable, naturally depending on the location of the primary tumour, with epistaxis and nasal obstruction being the most common presenting symptoms overall [6]. HNMM, unlike cutaneous melanoma, is not associated with sunlight exposure and the pathogenesis is not clearly understood [4]. However inhaled carcinogens, such as smoking and formaldehyde, have been implicated in the aetiology of this malignancy [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Head and neck mucosal melanoma: radiological considerations and UK imaging guidelines

Algudkar

Harrington

Kerawala

et al. 2023

Oral Maxillofac Surg

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Awareness of head and neck mucosal melanoma (HNMM) is important, as incorrect work-up can impact on the investigation and management of this rare and aggressive cancer. Following on from the 2020 HNMM UK guidelines, we set out the imaging recommendations and their rationale. To illustrate the key imaging characteristics, we also include a case series from our centre. MethodsAll HNMM cases managed at our institution from January 2016 to January 2021 were identi ed and the available imaging for each patient was reviewed. For each patient, the age, gender and location of primary tumour was recorded together with key staging and diagnostic imaging parameters. ResultsA total of 14 patients were identi ed. The median age was 65 years with a female to male ratio of 1.33:1. Primary tumours were sinonasal in location in 93% of cases, with 7% of patients having metastatic neck nodes at presentation and 21% of cases having distant metastatic disease at presentation. ConclusionThis data set is in general concordance with other published series regarding the sinonasal origin of the vast majority of HNMM tumours along with the proportion of patients with metastatic neck nodes and distant metastases at presentation. We recommend dual-modality imaging with computed tomography (CT) and magnetic resonance imaging (MRI) of primary tumours whenever possible. In the systematic staging of HNMM, positron emission tomography (PET)-CT should be strongly considered, together with MRI of the brain. Pre-biopsy imaging of HNMM tumours is advisable whenever possible.

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What is the role of the surgeon in the management of head and neck mucosal melanoma in the immunotherapy era?

Cited by 7 publications

References 28 publications

Epidemiology and outcomes of gastrointestinal mucosal melanomas: a national database analysis

Epidemiology and outcomes of gastrointestinal mucosal melanomas: a national database analysis

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

Head and neck mucosal melanoma: radiological considerations and UK imaging guidelines

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