title: Primary mucosal melanoma of the oral cavity: current therapy and future directions.
abstract: BACKGROUND
  Primary mucosal melanoma of the oral cavity is a highly aggressive malignancy of melanocytic origin. The aim of this study is to report a case series of oral mucosal melanomas (OMMs) and provide a review of the literature with regard to treatment guidelines for and prognosis of this pathologic entity.
  
  
  METHODS
  We report three cases of OMMs treated in our institutions and the results of a literature review, in which the words "oral" and "mucosal melanoma" were used as the main keywords.
  
  
  RESULTS
  Surgical resection of the primary tumor with wide resection margins appears to be the recommended primary treatment modality with the aim to achieve tumor-free margins. Elective neck dissection and adjuvant radiotherapy have been advocated for locoregional control. Chemotherapy has not been shown to improve survival and is mainly used for palliative purposes. Immunotherapy and biochemotherapy seem to significantly improve survival and could open new therapeutic horizons.
  
  
  CONCLUSIONS
  The prognosis of OMMs remains poor despite treatment. Early diagnosis and aggressive surgical resection followed by adjuvant therapies could be the key to improving survival. Multicenter randomized clinical trials, which may be difficult to conduct because of the rarity to the lesion, would aid in the development of new strategies.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Chatzistefanou
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Rochester, Rochester, New York, USA. Electronic address: Antonia_kolokythas@urmc.rochester.edu.
authors.forename: Antonia
authors.initials: A
authors.lastname: Kolokythas
authors.affiliation: Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vahtsevanos
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Rochester, Rochester, New York, USA.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Antoniades
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D011379:Prognosis