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Sinonasal mucosal melanomas: defining profiles for better survival outcomes

Volume: 60 - Issue: 5

First page: 347 - Last page: 356

M.J. Rojas-Lechuga - J.R. Gras-Cabrerizo - F.X. Aviles-Jurado - J. Malvehy - A.M. Arance - P. Castillo - A. Barreiro - S. Podlipnik - M. Lopez-Chacon - I. Alobid - M. Bernal Sprekelsen - S. Puig - C. Langdon

Background: Sinonasal mucosal melanoma is an aggressive malignancy with a 5-year survival rate ranging from 20% to 39%. Despite the evolving surgical and radiotherapy techniques, and introduction of immune-checkpoint inhibitor therapy, overall survival rates remain poor.
Methodology: A retrospective cohort study was conducted at the Hospital ClĂ­nic de Barcelona and the Hospital de la Santa Creu i Sant Pau between 1984 and 2020; primary outcome measures were 3 and 5-year melanoma-specific survival (MSS). Kaplan-Meier survival analysis and Cox proportional hazards model were performed to identify predictors of survival.
Results: Fifty patients were included, the mean age was 70.4, MSS at 3 and 5 years was 51.2%, and 29.5%, respectively. The median follow-up was 39.6 months during which 46% presented locoregional recurrence and 36%, metastasis. The univariate and multivariate analyses found as survival predictors the N category, the treatment received, the surgical margins and the mitotic index.
Conclusions: We found an overall 5-year MSS of 29.5%. Those patients with intention-to-cure (stages III and IVa) treated by surgery that were N0 at diagnosis, with < 10 mitoses per HPF showed a 5-year MSS rate of 74.1%. More studies will be needed to adequately define the patients’ profiles that will benefit from a better survival outcome.

Rhinology 60-5: 347-356, 2022

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