Radiotherapy in the treatment of mucosal melanoma of the upper aerodigestive tract: analysis of 74 cases. A Rare Cancer Network study.
OBJECTIVE
To retrospectively analyze a series of mucosal melanoma of the upper aerodigestive tract to determine the prognostic factors and contribute to understanding the role of radiotherapy in the therapeutic strategy.


METHODS
Seventy-four patients were analyzed. The most frequent locations were nasal and oral, in 31 patients (41.9%) and 12 patients (16.2%), respectively. Sixty-three patients (85.1%) were in Stage I, 5 (6.8%) in Stage II, and 6 (8.1%) in Stage III. Treatment consisted of surgery in 17 patients (23.0%), surgery and radiotherapy in 42 (56.8%), radiotherapy in 11 (14.9%), and chemo-immunotherapy in 4 (5.4%). Median follow-up was 20 months.


RESULTS
Local control at 3 years was 57% after surgery alone and 71% after surgery and radiotherapy. Overall and disease-free survival rates, respectively, were 41% and 31% at 3 years and 14% and 22% at 10 years. After univariate analysis, female gender, melanosis, tumor size </=3 cm, Stage I, postoperative radiotherapy, and complete remission were favorable prognostic factors. Stage I and melanosis were confirmed by multivariate analysis.


CONCLUSIONS
Local control was improved by postoperative radiotherapy, despite survival being as poor as in other published series. Stage I and melanosis at diagnosis were the most favorable prognostic factors.
Krengli
Marco
M
Department of Radiation Oncology, University of Piemonte Orientale, Novara, Italy. krengli@tera.it
Masini
Laura
L
Kaanders
Johannes H A M
JH
Maingon
Philippe
P
Oei
Swan Bing
SB
Zouhair
Abderrahim
A
Ozyar
Enis
E
Roelandts
Martine
M
Amichetti
Maurizio
M
Bosset
Mathieu
M
Mirimanoff
René-Olivier
RO
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008545:Melanoma / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D009061:Mouth Mucosa; D009062:Mouth Neoplasms / Q000532:radiotherapy / Q000601:surgery; D009297:Nasal Mucosa; D009669:Nose Neoplasms / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D011832:Radiation Injuries / Q000209:etiology; D012189:Retrospective Studies; D016019:Survival Analysis