title: Outcomes in patients with mucosal melanomas.
abstract: OBJECTIVE
  Our goal was to evaluate the different subtypes of mucosal melanoma and describe specific variables that predict outcomes.
  
  
  METHODS
  Prospective review of two tertiary care center databases identified 76 mucosal melanoma patients; 73 with complete records were included. Demographic and clinical data were analyzed. Cox regression determined variables impacting recurrence and survival.
  
  
  RESULTS
  In the 73 patients, the mean age was 64 years, and 74% were female. Sixty-seven percent presented with lymph node involvement, and 73% had ulcerated tumors. Major sites affected were nasal/palate/oral (36%), vulvar/vaginal/cervical (48%), and anorectal (15%). Mean overall and disease-free survival were 56.9 and 27.2 months. Variables associated with decreased survival included: lymphovascular invasion (HR17.70, P = 0.0093), Caucasian race (HR3.02, P = 0.0362), nasal/palate/oral sub-group (HR1.85, P = 0.026), Breslow thickness (HR1.23, P = 0.00004), T stage (HR1.34, P = 0.0075), M stage (HR3.03, P = 0.0039), and chemotherapy (HR3.13, P = 0.0002). The worst prognosis was seen in the nasal/palate/oral sub-group, with a median overall survival of 9.7 months and recurrence-free time of 4.5 months. This subtype also demonstrated high lymph node positivity, ulceration, and larger tumor size.
  
  
  CONCLUSIONS
  The nasal, palate, oral subtype has the worst prognosis compared to other mucosal melanoma locations. Studies are ongoing to evaluate pathologic and genomic variables that may predict outcomes.
authors.affiliation: Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Keller
authors.forename: Alan A
authors.initials: AA
authors.lastname: Thomay
authors.forename: John
authors.initials: J
authors.lastname: Gaughan
authors.forename: Anthony
authors.initials: A
authors.lastname: Olszanski
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
authors.forename: Adam C
authors.initials: AC
authors.lastname: Berger
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Farma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: cancer recurrence; cancer survival; mucosal melanoma; outcomes; skin cancer