The role of postoperative adjuvant radiation therapy in the treatment of mucosal melanomas of the head and neck region.
BACKGROUND
Mucosal melanoma of the head and neck is uncommon, and has a poor prognosis due to locoregional and distant failure. The optimal treatment paradigm for patients with this disease has yet to be determined.


OBJECTIVE
To compare the outcomes of patients treated with various commonly used protocols for mucosal melanoma of the head and neck.


METHODS
Retrospective study.


METHODS
Academic tertiary referral center.


METHODS
The medical records of 48 consecutive patients treated at a single institution from January 1, 1985, to December 31, 1998, were reviewed.


METHODS
Patients were treated with surgery alone, surgery and adjuvant radiotherapy, or surgery and biochemotherapy, with or without adjuvant radiotherapy.


METHODS
The outcomes of disease recurrence and survival were correlated with the treatment received.


RESULTS
Twenty patients received surgical treatment alone; in 9 patients (45%), this treatment failed locoregionally, and 10 (50%) of the patients developed distant metastases. The 5-year survival rate was 45% (9 of 20 patients). Twenty-four patients received postoperative adjuvant radiotherapy; in 4 patients (17%), this treatment failed locally, and 11 (46%) of the patients developed distant metastases. The 5-year survival rate was 29% (7 of 24 patients).


CONCLUSIONS
The addition of radiotherapy tended to decrease the rate of local failure (P =.13), but did not significantly improve survival (P =.73), because of the high rate of distant metastatic disease.
Owens
Jonathan M
JM
Department of Otolaryngology-Head and Neck Surgery, University of Colorado Health Sciences Center, Denver 80262, USA. jonathan.owens@uchsc.edu
Roberts
Dianna B
DB
Myers
Jeffrey N
JN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D009362:Neoplasm Metastasis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome