Impact of adjuvant therapy on survival for sinonasal mucosal melanoma

Abstract

Background: The optimal treatment modality for sinonasal mucosal melanoma (SNMM) remains controversial.

Objectives: To investigate the impact of adjuvant therapy on SNMM.

Material and methods: Ninety-two patients were retrospectively analyzed and were grouped into surgery alone (SA), surgery plus radiotherapy (SR), surgery plus chemotherapy (SC) and surgery plus radiochemotherapy (SRC) groups. Survival outcomes among different treatment modalities were analyzed using the Kaplan–Meier method and log-rank test.

Results: Twenty-nine patients (31.5%) developed local recurrence, 10 patients (10.9%) had nodal metastasis, and 41 patients (44.6%) had distant metastasis. The overall survival time (OS) for SA, SR and SRC were 16, 29 and 27 months, respectively, and the disease-free survival time (DFS) were 10, 16 and 16 months, respectively. Significant differences were found between SA and SR (OS: p = .003; DFS: p = .016) and SA and SRC (OS: p = .002; DFS: p = .008). Superior outcomes were also found in SRC group compared to that in SA group for both OS (15 vs. 27 months, p = .012) and DFS (10 vs. 20 months, p = .017) in endoscopic approach.

Conclusions and significance: SNMM had poor prognosis with high rates of local recurrence and metastasis. Adjuvant therapy improved survival outcomes for SNMM.

Chinese abstract

背景：鼻腔粘膜黑色素瘤（SNMM）的最佳治疗方式仍存有争议。

目的：探讨辅助治疗对SNMM的影响。

材料与方法：对92例患者进行回顾性分析, 将其分为单纯手术组（SA）、手术加放疗组（SR）、手术加化疗组（SC）和手术加放化疗组（SRC）。采用Kaplan-Meier法和对数秩检验来分析不同治疗方式的生存率。

结果：局部复发29例（31.5%）, 淋巴结转移10例（10.9%）, 远处转移41例（44.6%）。SA、SR和SRC的总生存期分别为16、29和27个月, 无病生存期分别为10、16和16个月。SA和SR（OS: p = .003；DFS: p = .016）和SA和SRC（OS: p = .002；DFS: p = .008）之间存在显著差异。SRC组在内镜手术中OS（15个月对27个月, p = .012）和DFS（10个月对20个月, p = .017）的疗效也优于SA组。

结论与意义：SNMM预后差, 局部复发转移率高。辅助治疗提高了SNMM的生存率。

Keywords:

• Sinonasal malignancy
• mucosal melanoma
• endoscopic surgery
• radiotherapy

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was funded by the Natural Science Foundation of Shanghai, China, under Grant 16ZR1405000 and the Natural Science Foundation of China under Grant 81600783.