title: Mucosal melanoma of the head and neck: a population-based study from Slovenia, 1985-2013.
abstract: OBJECTIVE
  To assess the incidence and to review experience with the treatment of mucosal melanoma of the head and neck (MMHN) in Slovenia between 1985 and 2013.
  
  
  METHODS
  The National Cancer Registry database and clinical records with outcome data of identified patients treated during the period 1985-2013 in Slovenia were reviewed.
  
  
  RESULTS
  In a 29-year period, 61 patients with MMHN were identified, representing 0.5 % of all head and neck malignant tumors and 42 % of all mucosal melanomas in Slovenia. 72 % originated in the sinonasal tract and were predominantly (78 %) diagnosed as a local disease. Regional metastases at diagnosis were more frequent in patients with oral/oropharyngeal primary (44 %; sinonasal MMHN 11 %, p = 0.006). Curative intent treatment was given to 48 (79 %) patients. The overall survival (OS) rates at 2 and 5 years for the whole cohort were 43 % and 18 %, respectively, and for the curative intent group 53 % and 24 %, respectively. In the latter group, multivariate analyses showed postoperative radiotherapy (PORT) to be predictive for locoregional control (LRC) (hazard ratios [HR] for surgery with PORT vs. surgery alone: 1.0 vs. 3.9, p = 0.037), whereas only the World Health Organization performance status (HR for grade 0 vs. grade 1 vs. grade >1: 1.0 (p = 0.022) vs. 1.2 (p = 0.640) vs. 7.7 (p = 0.008)) significantly influenced OS.
  
  
  CONCLUSIONS
  MMHN is a rare tumor with a poor prognosis. Combination of surgery and PORT offers the best prospects for LRC but without improvement of OS. Due to potential toxicity of high-dose RT such treatment is indicated in patients in whom LRC outweighs the risks of serious adverse effects.
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
authors.forename: Gaber
authors.initials: G
authors.lastname: Plavc
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
authors.forename: Jasna
authors.initials: J
authors.lastname: But-Hadžić
authors.affiliation: University Department of Otorhinolaryngology and Cervicofacial Surgery, University Clinical Center, Ljubljana, Slovenia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Aničin
authors.affiliation: Department of Otorhinolaryngology, Cervical and Maxillofacial Surgery, University Clinical Center, Maribor, Slovenia.
authors.forename: Boštjan
authors.initials: B
authors.lastname: Lanišnik
authors.affiliation: Department of Maxillofacial and Oral Surgery, University Clinical Center, Ljubljana, Slovenia.
authors.forename: Vojislav
authors.initials: V
authors.lastname: Didanović
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia. pstrojan@onko-i.si.|Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. pstrojan@onko-i.si.
authors.forename: Primož
authors.initials: P
authors.lastname: Strojan
mesh_terms: D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008545:Melanoma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D017524:Slovenia / Q000453:epidemiology; D017741:Survivors; D013997:Time Factors; D017211:Treatment Failure
keywords: Epidemiology; Head and neck cancer; Mucosal melanoma; Survival; Therapy