S149 – Sinonasal Mucosal Melanoma: A 12‐Year Experience

Objectives 1) Describe the Sinonasal Mucosal Melanoma patients (SNMM) our institution has treated. 2) Assess outcomes of surgical and adjuvant therapies for this disease. Methods Records of 18 patients diagnosed between 1995 and 2007 were reviewed, with a focus on patient characteristics, treatment outcomes, and modalities. Results Patients’ ages ranged from 31 to 85. Most common anatomic locations were maxillary sinus in 12 patients and lateral nasal walls in 6. 5 patients had cribriform plate involvement, and 3 had orbital involvement. Tumor thickness averaged 3.1 cm. 15 of the 18 patients had definitive surgical resection of their primary. Most common surgical procedure was medial maxillectomy. 6 patients were operated on despite disease in prognostically poor locations such as skull base, orbit, cribiform plate, and nasopharynx. Margins ranged from 0.5 to 4 cm. 10 patients received chemo‐ or immunotherapy, 11 received radiotherapy, and 6 received both. Recurrence rate was 10/18 (55%), while distant metastatic rate was 6/18 (33%), the lung being the most common metastatic location (4 patients). Average follow‐up was 38.6 months, with disease‐free intervals ranging from 8 to 39 months in patients with recurrences. After 2000, patients only received limited surgical resections, and were treated at stages I‐II. Conclusions Despite the poor prognosis of SNMM, over the past 13 years at our institution the trend has been towards patients being diagnosed and treated at an earlier stage and having less extensive surgical resections. Advances in imaging, negative margins, radiation, and the use of immunotherapy may have influenced patient outcomes and recurrence rates.