title: Predictors of survival in mucosal melanoma of the head and neck.
abstract: BACKGROUND
  The head and neck is the most common site of mucosal melanoma, a cancer with poor prognosis. In contrast to cutaneous melanoma, mucosal melanoma of the head and neck (MMHN) is uncommon, with limited data regarding outcomes and prognostic factors drawn from small, single-institution case series. In order to identify factors predictive of survival, we analyzed MMHN outcomes in a large US cohort.
  
  
  METHODS
  MMHN cases (n = 815) diagnosed in the USA between 1973 and 2007 were analyzed in the Surveillance, Epidemiology, and End Results registry, and cause of death was individually determined in 778 (95.5%) cases. Kaplan-Meier survival analysis and Cox proportional hazards regression were used to analyze prognostic variables.
  
  
  RESULTS
  Disease-specific survival status was determined in 778 (95.5%) cases. The 5- and 10-year rates of overall survival (OS) were 25.2 and 12.2%; disease-specific survival (DSS), 32.4 and 19.3%. On multivariable analysis, anatomic primary site was an independent predictor of OS and DSS, with tumors in the nasal cavity and oral cavity associated with survival superior to tumors in the nasopharynx and paranasal sinuses. Age > 70 years, tumor size, nodal status, and distant metastasis status were additional independent predictors of poorer survival.
  
  
  CONCLUSIONS
  In this large cohort of patients with MMHN, we have identified several novel factors robustly predictive of overall and melanoma-specific survival.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Jethanamest
authors.forename: Peter M
authors.initials: PM
authors.lastname: Vila
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Sikora
authors.forename: Luc G T
authors.initials: LG
authors.lastname: Morris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D012307:Risk Factors; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D055815:Young Adult