title: Head and neck mucosal melanoma: clinicopathological analysis of 51 cases treated in a single cancer centre and review of the literature.
abstract: Head and neck mucosal melanoma (HNMM) is a rare and aggressive malignancy. The objective of this study was to describe the outcomes of patients with HNMM. Clinical and pathological data from 51 patients with primary HNMM were reviewed. All patients were treated at a single cancer centre between 1954 and 2012. Most tumours involved the nasal cavity (35.3%) and upper gingiva (29.4%). The majority of lesions were ulcerated (54.9%) and pigmented (84.3%). Forty-three patients underwent surgical treatment and 21 (41.2%) underwent adjuvant chemotherapy and/or radiotherapy. Eight patients (15.7%) received palliative treatment. The median follow-up period was 21 months. During this period, 30 (58.8%) patients had tumour recurrences. At the last clinical evaluation, only seven (13.7%) patients were alive with no evidence of disease and three (5.9%) were alive with HNMM. There were significant differences in overall survival probability according to the presence of ulceration (P=0.004), metastatic lymph nodes (P=0.003), and treatment including a radical surgical procedure (P<0.001). On multivariate analysis, ulceration was the only variable associated with an increased risk of death. Despite the poor prognosis, there was significant improvement in overall survival in the most recent years in this sample, mainly due to advances in diagnosis and reconstruction techniques.
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre and National Institute of Science and Technology in Oncogenomics (INCITO), São Paulo, Brazil.
authors.forename: A L N
authors.initials: AL
authors.lastname: Francisco
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre and National Institute of Science and Technology in Oncogenomics (INCITO), São Paulo, Brazil.
authors.forename: M V
authors.initials: MV
authors.lastname: Furlan
authors.affiliation: Department of Pathology, A. C. Camargo Cancer Centre, São Paulo, Brazil.
authors.forename: P M
authors.initials: PM
authors.lastname: Peresi
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre and National Institute of Science and Technology in Oncogenomics (INCITO), São Paulo, Brazil.
authors.forename: I N
authors.initials: IN
authors.lastname: Nishimoto
authors.affiliation: Department of Pathology, A. C. Camargo Cancer Centre, São Paulo, Brazil.
authors.forename: S V
authors.initials: SV
authors.lastname: Lourenço
authors.affiliation: Department of Pathology, A. C. Camargo Cancer Centre, São Paulo, Brazil.
authors.forename: C A L
authors.initials: CA
authors.lastname: Pinto
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre and National Institute of Science and Technology in Oncogenomics (INCITO), São Paulo, Brazil.
authors.forename: L P
authors.initials: LP
authors.lastname: Kowalski
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Centre and National Institute of Science and Technology in Oncogenomics (INCITO), São Paulo, Brazil. Electronic address: mauromakaike@terra.com.br.
authors.forename: M K
authors.initials: MK
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009297:Nasal Mucosa / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: epidemiology; head and neck; mucosal melanoma; prognosis; survival; treatment