Failure patterns and prognostic factors of patients with primary mucosal melanoma of the nasal cavity and paranasal sinuses

Abstract

Objectives: To analyse the failure patterns and prognostic factors influencing survival in patients with primary mucosal melanoma of the nasal cavity and paranasal sinuses.

Materials and methods: Fifty-one patients were analysed retrospectively. Forty-eight, 33, 10, and 13 patients underwent surgery, radiotherapy, chemotherapy, and immunotherapy, respectively. Failure events, including local recurrence, regional relapse, distant metastases, and death, were examined.

Results: During follow-up (median: 59.0 months), 36 patients experienced failure after treatment, including local (n = 17), regional (n = 8), and distant organ (n = 23) metastases. The median failure times for local, regional, and distant metastases were 13.0, 14.0, and 8.0 months, respectively. The median survival times from local, regional, and distant failure to death were 10.5, 8.0, and 4.0 months, respectively. The 5-year overall survival rates of patients with and without distant organ metastases were 14.4% and 72.6%, respectively (p < .001). Multivariate analyses showed that radiotherapy increased local recurrence-free and regional relapse-free survival. Patients with stage IV tumours had reduced distant metastasis-free and overall survival compared to patients with stage I–III tumours.

Conclusions: Distant metastasis was mainly owing to failure. Radiotherapy and the disease stage were prognostic factors for survival.

Chinese abstract

目的：分析影响鼻腔原发性鼻黏膜黑色素瘤和鼻旁窦患者生存的失败模式和预后因素。

材料与方法：回顾性分析了51例患者。 48例、33例、10例和13例患者分别接受了手术、放射治疗、化疗和免疫治疗。检查了局部复发、区域复发、远处转移和死亡等失败事件。

结果：随访（中位数：59.0个月）过程中, 36例患者经历治疗后失败, 包括局部（n = 17）、区域性（n = 8）和远处器官（23例）的转移。局部、区域和远处转移的中位失败时间分别为13.0、14.0和8.0个月。从局部、区域和远程失败到死亡的中位数生存时间分别为10.5、8.0和4.0个月。有和无远处器官转移患者的5年总体生存率分别为14.4%和72.6%（p <0.001）。多变量分析显示放射治疗增加局部无复发和区域无复发生存。 IV期肿瘤患者与I-III期肿瘤患者相比, 远处无转移和总体生存率降低。

结论：远处转移主要是由于治疗失败。放射治疗和疾病阶段是预后的生存因素。

Keywords:

• Melanoma
• nasal cavity
• neoplasm metastasis
• paranasal sinuses
• prognosis
• recurrence

Acknowledgments

We wish to thank Editage (www.editage.cn) for English language editing.

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sector.

Failure patterns and prognostic factors of patients with primary mucosal melanoma of the nasal cavity and paranasal sinuses.