title: Management of sinonasal mucosal melanomas and comparison of classification staging systems.
abstract: OBJECTIVE
  The aim of this study was to describe treatment results in patients with sinonasal mucosal melanomas (SMMs) and to compare three different classification staging systems.
  
  
  METHODS
  From 1988 to 2013, we performed a retrospective study of 20 patients with primary sinonasal melanomas. The median age at diagnosis was 71 years. There were 10 males and 10 females.
  
  
  RESULTS
  Nine SMMs (45%) were originated in the ethmoidal sinus complex, four (20%) in the inferior turbinate, three (15%) in the nasal septum, two (10%) in the maxillary sinus, and two (10%) in the nasal vestibule. Local recurrence was diagnosed in eight patients (40%), and six out of 20 patients (30%) developed distant metastasis during the course of their disease. The adjusted survival rates at three and five years were 47% and 34%, respectively. The adjusted three-year survival rate according to the sinonasal staging system 7th edition for SMM (TNM-SMM) was 60% in T3 stage, 50% in T4a stage, and 34% in T4b stage (p = 0.05). According to Thompson's staging system, survival was 33% for group one, 58% for group two, and 0% for group three (p = 0.006). With the sinonasal staging system 7th edition for carcinoma (TNM-CAR) survival was 33% in T1, 100% in T2 and T3, 0% in T4a, and 34% in T4b (p = 0.006).
  
  
  CONCLUSIONS
  Our experience confirms the distribution of patients according to survival rates was better with the TNM-SMM than with Thompson's or the TNM-CAR systems.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.
authors.forename: Juan R
authors.initials: JR
authors.lastname: Gras-Cabrerizo
authors.forename: Xavier
authors.initials: X
authors.lastname: León-Vintró
authors.forename: Margarita Majem
authors.initials: MM
authors.lastname: Tarruella
authors.forename: Gabriel Pedemonte
authors.initials: GP
authors.lastname: Sarria
authors.forename: Carolina Bothe
authors.initials: CB
authors.lastname: Gonzalez
authors.forename: Joan R
authors.initials: JR
authors.lastname: Montserrat-Gili
authors.forename: Katherina
authors.initials: K
authors.lastname: Kolanczak
authors.forename: Humbert
authors.initials: H
authors.lastname: Massegur-Solench
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000473:pathology*; D012189:Retrospective Studies; D015996:Survival Rate