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Importance of Margins, Radiotherapy, and Systemic Therapy in Mucosal Melanoma of the Head and Neck
Author(s) -
Sahovaler Axel,
Ziai Hedyeh,
Cardemil Felipe,
Huang Shao Hui,
Su Jie,
Goldstein David P.,
Gilbert Ralph,
Hosni Ali,
Hope Andrew,
Waldron John,
Spreafico Anna,
Monteiro Eric,
Witterick Ian,
Irish Jonathan,
Gullane Patrick,
Xu Wei,
O'Sullivan Brian,
Almeida John R.
Publication year - 2021
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.29555
Subject(s) - medicine , radiation therapy , retrospective cohort study , mucosal melanoma , head and neck , systemic therapy , melanoma , immunotherapy , surgery , oncology , disease , cancer , breast cancer , cancer research
Objectives/Hypothesis The ideal strategy in the treatment of mucosal melanoma of the head and neck (MMHN) remains unclear. Our objective was to evaluate the importance of surgical margins, radiotherapy, and systemic therapy in MMHN. Study Design Retrospective Single Institutional Review. Methods Retrospective review of patients with MMHN treated at a tertiary care oncology center between 1999 and 2016. Results Seventy‐six patients were included, 60 of whom were treated with curative intent. Negative or close margins compared with positive margins were associated with higher 3‐year overall survival (OS) (62% vs. 29% vs. 13% P = .012), disease‐free survival (33% vs. 29% vs. 4% P = .003), and distant control (48% vs. 29% vs. 22% P = .039). Cases with pre‐/postoperative radiotherapy had a marginally higher locoregional control versus without (69% vs. 59%, P = .117). Immunotherapy for recurrent and/or metastatic disease was associated with an increase in 3‐year OS (15% vs. 3% P = .01). Conclusion Achieving negative surgical margins is relevant in disease control. Despite small sample size, our data suggest that radiotherapy may enhance surgical outcomes. Immunotherapy has therapeutic benefit. Level of Evidence 3 Laryngoscope , 131:2269–2276, 2021