Mucosal Melanomas of the Head and Neck—a Tertiary Cancer Centre Experience

Abstract

Mucosal melanoma is a relatively rare tumour of the head and neck with a very poor prognosis. Managing this disease entity becomes more difficult due to high chances of disease failure locoregionally and at distant sites. This study assessed the treatment outcomes and factors affecting prognosis of head and neck mucosal melanomas. Forty-one cases of mucosal melanomas of head and neck (MMHN) treated in our institution during 10 years were retrospectively reviewed. Data regarding the clinicopathological parameters and treatment outcomes was collected. Survival was calculated using Kaplan-Meier method. The most common subsite of MMHN was upper alveolus and hard palate (39%). Thirty-one of the 41 cases underwent surgery whereas 10 cases were treated with palliative intent. At presentation, 15 of 41 cases had lymph node involvement and majority of them had primary in the oral cavity: sinonasal region had low chances of lymph node metastasis. Seventy-four percent of cases underwent adjuvant post-operative radiotherapy. For surgically treated cases, 5-year disease-specific survival (DSS) was 35.7%. Mucosal melanomas of nose and paranasal sinuses had a better overall survival than oral cavity. Distant metastasis was the most common cause of disease failure in 12 of 24 cases and had a significant association with disease-specific survival. The stage of the disease was a significant prognostic indicator. Sinonasal cavity mucosal melanomas have a better prognosis than mucosal melanomas in other subsites. Overall survival for surgically treated cases was significantly better than cases treated non-surgically. Presence of lymph node metastasis reduced the survival by 50% in MMHN.