title: Treatment outcomes of sinonasal malignant melanoma: a Korean multicenter study.
abstract: BACKGROUND
  The aim of this work was to evaluate factors that influence local recurrence and survival after surgical resection of sinonasal malignant melanoma, using a large population-based multicenter study in Korea.
  
  
  METHODS
  Retrospective analysis was performed for 155 newly diagnosed sinonasal malignant melanoma patients gathered from 15 university hospitals throughout Korea. Demographic data, tumor characteristics, surgical approach, adjuvant treatment, recurrence, and outcomes were analyzed.
  
  
  RESULTS
  Three-year and 5-year overall survival rates were 48.8% and 40.1%, respectively. Local recurrence rate was 46.6%, with a mean recurrence time of 15.5 months. On multivariate analysis, patients who underwent surgery that included an endoscopic approach showed decreased local recurrence rate (p = 0.042) and increased survival rate (hazard ratio [HR], 1.702; 95% confidence interval [CI], 1.007 to 2.875; p = 0.047) compared to those who underwent an external approach. Patients with postoperative radiotherapy showed a decreased local recurrence rate (p = 0.001), but without impact on survival rate. Male gender, tumor beyond the nasal cavity, and presence of distant metastasis were associated with poor survival.
  
  
  CONCLUSIONS
  An endoscopic-including surgical approach was associated with improved local control and survival in sinonasal malignant melanoma patients. Postoperative radiotherapy helped increase the local control rate.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Tae-Bin
authors.initials: TB
authors.lastname: Won
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Kyu Young
authors.initials: KY
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chae-Seo
authors.initials: CS
authors.lastname: Rhee
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Hong-Ryul
authors.initials: HR
authors.lastname: Jin
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, Seoul, Korea.
authors.forename: Jong Sook
authors.initials: JS
authors.lastname: Yi
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Seoul, Korea.
authors.forename: Hun-Jong
authors.initials: HJ
authors.lastname: Dhong
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Ji Ho
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Hospital, Seoul, Korea.
authors.forename: Jin Kook
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, Korea.
authors.forename: Young-Jun
authors.initials: YJ
authors.lastname: Chung
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Yong-Min
authors.initials: YM
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Gyeongsang National University Hospital, Jinju, Korea.
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chonbuk National University Hospital, Jeonju, Korea.
authors.forename: Sam Hyun
authors.initials: SH
authors.lastname: Kwon
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Hwasun Hospital, Gwangju, Korea.
authors.forename: Sang-Chul
authors.initials: SC
authors.lastname: Lim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Hwan-Jung
authors.initials: HJ
authors.lastname: Roh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007723:Korea; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009669:Nose Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D044382:Population Groups; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: melanoma; nasal cavity; paranasal sinuses; recurrence; survival