Head and neck mucosal melanoma.
OBJECTIVE
The purpose of this article is to discuss the optimal treatment and outcomes for head and neck mucosal melanoma.


METHODS
Review the pertinent literature.


RESULTS
Head and neck mucosal melanoma is a rare entity comprising less than 1% for all Western melanomas. It usually arises in the nasal cavity, paranasal sinuses, and oral cavity. The optimal treatment is surgery. The likelihood of local recurrence after resection is approximately 50%. Radiotherapy (RT) reduces the likelihood of local failure but probably does not enhance survival, which is primarily impacted by advanced T stage and the presence of regional metastases. The 5-year survival rates vary from approximately 20 to 50%. Although the median time to relapse is roughly 1 year or less, late failures are common and cause-specific survival continues to decline after 5 years.


CONCLUSIONS
The optimal treatment is surgery. Postoperative RT improves local-regional control but may not impact survival. Definitive RT may occasionally cure patients with unresectable local-regional disease or at least provide long-term palliation.
Mendenhall
William M
WM
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA.
Amdur
Robert J
RJ
Hinerman
Russell W
RW
Werning
John W
JW
Villaret
Douglas B
DB
Mendenhall
Nancy Price
NP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007167:Immunotherapy; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D009092:Mucous Membrane / Q000473:pathology*; D009297:Nasal Mucosa / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D010157:Palatal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D016896:Treatment Outcome