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Treatment modalities in sinonasal mucosal melanoma: A national cancer database analysis
Author(s) -
Ganti Ashwin,
Raman Anish,
Shay Aryan,
Kuhar Hannah N.,
Auger Samuel R.,
Patel Tirth,
Kuan Edward C.,
Diaz Aidnag Z.,
Batra Pete S.,
Tajudeen Bobby A.
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27995
Subject(s) - medicine , hazard ratio , confidence interval , proportional hazards model , cancer , oncology , retrospective cohort study , multivariate analysis , univariate analysis , stage (stratigraphy) , survival analysis , melanoma , radiation therapy , immunotherapy , cancer research , paleontology , biology
Objectives/Hypothesis The purpose of this study was to investigate the association of demographic factors, tumor stage, and treatment modalities for overall survival in patients with sinonasal mucosal melanoma (SNMM). Study Design Retrospective database review. Methods The National Cancer Database was queried for patients of all ages with SNMM between 2004 and 2015. Univariate Kaplan‐Meier and multivariate Cox regression analyses were performed to evaluate the association of suspected prognostic factors with overall survival. Results A total of 1,874 patients with SNMM were included in the analysis. The 5‐year overall survival was 24%. Prognostic factors associated with decreased survival include advanced age (hazard ratio [HR]: 1.02, 95% confidence interval [CI]: 1.01‐1.03), T4 disease (HR: 1.44, 95% CI: 1.09‐1.89), and presence of distant metastases (HR: 3.22. 95% CI: 2.06‐5.04). Improved survival was associated with surgical resection only when margins were negative (HR: 0.44; 95% CI: 0.30‐0.65). In patients with metastatic disease, administration of immunotherapy (HR: 0.14; 95% CI: 0.04‐0.49) was associated with improved survival. Surgical approach, radiotherapy, and chemotherapy were nonsignificant predictors of survival. Conclusions This investigation is the largest to date to analyze the association of treatment modalities with overall survival in SNMM. Surgery remains the mainstay of treatment in patients with SNMM. However, administration of immunotherapy may confer survival benefit to patients with metastatic disease. Level of Evidence NA Laryngoscope , 130:275–282, 2020