Clinical characterization and treatment of head and neck mucosal melanoma: a Chilean experience

Abstract

Head and neck mucosal melanoma (HNMM) is a rare disease with a poor prognosis. The aim of this research was to analyze clinical characteristics and prognostic factors in a Latin American cohort. A retrospective chart review of patients with HNMM treated between 2008 and 2019 was conducted. Demographic characteristics, tumor characteristics, surgical treatment, adjuvant therapy, and oncologic outcomes were recorded. Twenty HNMMs were identified; 60% were in men. The most frequent primary location was the nasal cavity (10; 50%). Regional disease was uncommon and limited to the oral cavity. The median overall survival was 29 months; the 3- and 5-year overall survival rates were 37.2% and 26.6%, respectively. Univariate analysis revealed that predictors of a worse overall survival were paranasal location (hazard ratio [HR], 4.61; 95% confidence interval [CI], 1.61-18.40; P=.030), positive lymph nodes (HR, 6.00; 95% CI, 1.30-27.7; P=.022), positive margins (HR, 4.32; 95% CI, 1.08-17.2; P=.039), bone invasion (HR, 3.27;95% CI, 1.05-10.1; P=.041), and lymphovascular invasion (HR, 3.82; CI, 1.03-14.2; P=.045). Three-year recurrence-free survival was 17.3%, and most of the recurrences were with distant disease. HNMM is an infrequent disease with an aggressive behavior. Survival outcomes are related to location of the primary disease, regional spread, lymphovascular invasion, and bone invasion.