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J Neurol Surg B Skull Base 2012; 73(03): 157-162
DOI: 10.1055/s-0032-1301400
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Survival in Sinonasal Melanoma: A Meta-analysis

Mitchell R. Gore
1   Division of Skull Base Surgery/Rhinology, Department of Otolaryngology–Head and Neck Surgery, UNC-Chapel Hill School of Medicine, Chapel Hill, North Carolina
,
Adam M. Zanation
1   Division of Skull Base Surgery/Rhinology, Department of Otolaryngology–Head and Neck Surgery, UNC-Chapel Hill School of Medicine, Chapel Hill, North Carolina
› Author Affiliations
Further Information

Publication History

09 July 2011

18 October 2011

Publication Date:
22 February 2012 (online)

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Abstract

Sinonasal melanoma is an uncommon tumor which carries a poor prognosis and high rates of local and regional recurrence and distant metastasis. While surgical resection is the mainstay of treatment, the utility of multimodality therapy has not been well studied or established. We sought to better evaluate the optimal treatment modality for sinonasal melanoma. We reviewed 39 case reports involving 423 patients with sinonasal melanoma and present a meta-analysis comparing survival by treatment modality. The two-tailed p-value for survival by treatment modality was determined. The number of primary site/local, regional, and distant recurrences was determined where data was available. There was a nonsignificant increase in survival for patients treated with surgery + radiotherapy versus surgery alone. There was a statistically significant increase in survival for surgery + chemotherapy versus chemotherapy alone and versus surgery alone. Patients treated with combined surgery, radiation, and chemotherapy had a statistically shorter survival interval than patients treated with surgery + chemotherapy, which may reflect more advanced disease in patients treated with triple therapy. There was no statistically significant increase in survival found for the addition of radiation to surgery. This meta-analysis demonstrates that multimodality therapy, particularly the addition of chemo-or immunotherapy to surgery, may increase survival in a subset of patients. Radiation therapy did not appear to increase survival. There may be a significant increase in overall survival with combined modality therapy with surgery and chemo/immunotherapy versus single modality therapy. Level of evidence: III. Grade of recommendation: C.

Keywords

sinonasal - melanoma - skull base - endoscopic
 

  • References

  • 1 Dwivedi R, Dwivedi R, Kazi R, Kumar S, Agarwal SP. Mucosal melanoma of nasal cavity and paranasal sinus. J Cancer Res Ther 2008; 4 (4) 200-202
    CrossrefPubMedGoogle Scholar
  • 2 Kuo CT, Hoon DS, Takeuchi H , et al. Prediction of disease outcome in melanoma patients by molecular analysis of paraffin-embedded sentinel lymph nodes. J Clin Oncol 2003; 21 (19, Issue 19) 3566-3572
    CrossrefPubMedGoogle Scholar
  • 3 Wagner M, Morris CG, Werning JW, Mendenhall WM. Mucosal melanoma of the head and neck. Am J Clin Oncol 2008; 31 (1) 43-48
    CrossrefPubMedGoogle Scholar
  • 4 Choi YS, Han GS, Choi JS, Jang TY. Two cases of malignant melanoma in turbinate and maxillary sinus. Eur Arch Otorhinolaryngol 2006; 263 (11) 996-1000
    CrossrefPubMedGoogle Scholar
  • 5 Narasimhan K, Kucuk O, Lin H-S , et al. Sinonasal mucosal melanoma: a 13-year experience at a single institution. J Neurol Surg B 2009; 19 (4) 255-262
    PubMedGoogle Scholar
  • 6 Cheng YF, Lai CC, Ho CY, Shu CH, Lin CZ. Toward a better understanding of sinonasal mucosal melanoma: clinical review of 23 cases. J Chin Med Assoc 2007; 70 (1, Issue 1) 24-29
    CrossrefPubMedGoogle Scholar
  • 7 Thompson LD, Wieneke JA, Miettinen M. Sinonasal tract and nasopharyngeal melanomas: a clinicopathologic study of 115 cases with a proposed staging system. Am J Surg Pathol 2003; 27 (5) 594-611
    CrossrefPubMedGoogle Scholar
  • 8 Kardon DE, Thompson LD. Sinonasal mucosal malignant melanoma: report of an unusual case mimicking schwannoma. Ann Diagn Pathol 2000; 4 (5) 303-307
    CrossrefPubMedGoogle Scholar
  • 9 Dauer EH, Lewis JE, Rohlinger AL, Weaver AL, Olsen KD. Sinonasal melanoma: a clinicopathologic review of 61 cases. Otolaryngol Head Neck Surg 2008; 138 (3) 347-352
    CrossrefPubMedGoogle Scholar
  • 10 Moreno MA, Hanna EY. Management of mucosal melanomas of the head and neck: did we make any progress?. Curr Opin Otolaryngol Head Neck Surg 2010; 18 (2) 101-106
    CrossrefPubMedGoogle Scholar
  • 11 Slavik T, Hannah M, Schroder RA. Primary chondroid melanoma of the nasal skin: a rare melanoma variant at a previously undocumented site. J Cutan Pathol 2007; 34 (5) 427-430
    CrossrefPubMedGoogle Scholar
  • 12 McLean N, Tighiouart M, Muller S. Primary mucosal melanoma of the head and neck. Comparison of clinical presentation and histopathologic features of oral and sinonasal melanoma. Oral Oncol 2008; 44 (11) 1039-1046
    CrossrefPubMedGoogle Scholar
  • 13 Racic G, Kurtovic D, Roje Z, Tomic S, Dogas Z. Primary mucosal melanoma of the eustachian tube. Eur Arch Otorhinolaryngol 2004; 261 (3) 139-142
    CrossrefPubMedGoogle Scholar
  • 14 McLean N, Tighiouart M, Muller S. Primary mucosal melanoma of the head and neck. Comparison of clinical presentation and histopathologic features of oral and sinonasal melanoma. Oral Oncol 2008; 44 (11) 1039-1046
    CrossrefPubMedGoogle Scholar
  • 15 Dauer EH, Lewis JE, Rohlinger AL, Weaver AL, Olsen KD. Sinonasal melanoma: a clinicopathologic review of 61 cases. Otolaryngol Head Neck Surg 2008; 138 (3) 347-352
    CrossrefPubMedGoogle Scholar
  • 16 Rinaldo A, Shaha AR, Patel SG, Ferlito A. Primary mucosal melanoma of the nasal cavity and paranasal sinuses. Acta Otolaryngol 2001; 121 (8) 979-982
    PubMedGoogle Scholar
  • 17 Lynch SC, Lee AG, Graham SM, Kirby PA. Primary melanoma of the sphenoid sinus presenting with a third cranial nerve palsy. J Neuroophthalmol 2005; 25 (4) 289-292
    CrossrefPubMedGoogle Scholar
  • 18 Carter TR. Pathologic quiz case 1. Malignant melanoma. Arch Otolaryngol Head Neck Surg 1986; 112 (4) 450-453
    CrossrefPubMedGoogle Scholar
  • 19 Shinbori T, Uyama E, Eto K, Kohrogi H, Araki S. [An autopsy case of malignant melanoma possibly originating in the sphenoid sinus]. Rinsho Shinkeigaku 1988; 28 (6) 636-642
    PubMedGoogle Scholar
  • 20 Pino Rivero V, Keituqwa Yánez T, Marcos García M, Trinidad Ruíz G, Pardo Romero G, Blasco Huelva A. [Melanoma of sphenoid sinus. Case presentation and review of literature]. Acta Otorrinolaringol Esp 2004; 55 (1) 45-48
    PubMedGoogle Scholar
  • 21 Kung B, Deschenes GR, Keane W, Cunnane M, Jacob-Ampuero MP, Rosen M. Paranasal sinus melanoma masquerading as chronic sinusitis and nasal polyposis. Ear Nose Throat J 2007; 86 (9) 561-564
    PubMedGoogle Scholar
  • 22 Martin JM, Porceddu S, Weih L, Corry J, Peters LJ. Outcomes in sinonasal mucosal melanoma. ANZ J Surg 2004; 74 (10) 838-842
    CrossrefPubMedGoogle Scholar
  • 23 Ferraro RE, Schweinfurth JM, Highfill GR. Mucosal melanoma of the sinonasal tract. Am J Otolaryngol 2002; 23 (5) 321-323
    CrossrefPubMedGoogle Scholar
  • 24 Wagner M, Morris CG, Werning JW, Mendenhall WM. Mucosal melanoma of the head and neck. Am J Clin Oncol 2008; 31 (1) 43-48
    CrossrefPubMedGoogle Scholar
  • 25 Rinaggio J, Hameed M, Baredes S. Melanoma with cartilaginous differentiation originating within the mucosa of the nasal cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106 (6) 861-865
    CrossrefPubMedGoogle Scholar
  • 26 Eyden B, Pandit D, Banerjee SS. Malignant melanoma with neuroendocrine differentiation: clinical, histological, immunohistochemical and ultrastructural features of three cases. Histopathology 2005; 47 (4) 402-409
    CrossrefPubMedGoogle Scholar
  • 27 Sanderson AR, Gaylis B. Malignant melanoma of the sinonasal mucosa: two case reports and a review. Ear Nose Throat J 2007; 86 (5) 287-289, 294
    PubMedGoogle Scholar
  • 28 Dass A, Virk RS, Hundal H, Mohan H. Malignant melanoma of the mucous membranes of the head and neck: three case reports. Ear Nose Throat J 2006; 85 (4) 268-270
    PubMedGoogle Scholar
  • 29 Malaguarnera M, Vinci M, Pistone G. Malignant melanoma of nasal cavity: case report and review of the literature. Cancer Biother Radiopharm 2002; 17 (1) 29-34
    CrossrefPubMedGoogle Scholar
  • 30 Combs SE, Konkel S, Schulz-Ertner D , et al. Intensity modulated radiotherapy (IMRT) in patients with carcinomas of the paranasal sinuses: clinical benefit for complex shaped target volumes. Radiat Oncol 2006; 1: 23
    CrossrefPubMedGoogle Scholar
  • 31 Hofbauer GF, Böni R, Simmen D , et al. Histological, immunological and molecular features of a nasal mucosa primary melanoma associated with nasal melanosis. Melanoma Res 2002; 12 (1) 77-82
    CrossrefPubMedGoogle Scholar
  • 32 Helsel JC, Bardales RH, Mukunyadzi P. Fine-needle aspiration biopsy cytology of malignant neoplasms of the sinonasal tract. Cancer 2003; 99 (2) 105-112
    CrossrefPubMedGoogle Scholar
  • 33 Bridger AG, Smee D, Baldwin MA, Kwok B, Bridger GP. Experience with mucosal melanoma of the nose and paranasal sinuses. ANZ J Surg 2005; 75 (4) 192-197
    CrossrefPubMedGoogle Scholar
  • 34 Podboj J, Smid L. Endoscopic surgery with curative intent for malignant tumors of the nose and paranasal sinuses. Eur J Surg Oncol 2007; 33 (9) 1081-1086
    CrossrefPubMedGoogle Scholar
  • 35 Poetker DM, Toohill RJ, Loehrl TA, Smith TL. Endoscopic management of sinonasal tumors: a preliminary report. Am J Rhinol 2005; 19 (3) 307-315
    PubMedGoogle Scholar
  • 36 Feeley C, Theaker J. Epithelial markers in primary sinonasal mucosal melanoma. Histopathology 2004; 45 (1) 96-98
    CrossrefPubMedGoogle Scholar
  • 37 Lund VJ, Howard DJ, Harding L, Wei WI. Management options and survival in malignant melanoma of the sinonasal mucosa. Laryngoscope 1999; 109 (2 Pt 1) 208-211
    CrossrefPubMedGoogle Scholar
  • 38 Díaz Molina JP, Rodrigo Tapia JP, Llorente Pendas JL, Suárez Nieto C. [Sinonasal mucosal melanomas. Review of 17 case]. Acta Otorrinolaringol Esp 2008; 59 (10) 489-493
    CrossrefPubMedGoogle Scholar
  • 39 Tabaee A, Nyquist G, Anand VK, Singh A, Kacker A, Schwartz TH. Palliative endoscopic surgery in advanced sinonasal and anterior skull base neoplasms. Otolaryngol Head Neck Surg 2010; 142 (1) 126-128
    CrossrefPubMedGoogle Scholar
  • 40 Roth TN, Gengler C, Huber GF, Holzmann D. Outcome of sinonasal melanoma: clinical experience and review of the literature. Head Neck 2010; 32 (10) 1385-1392
    CrossrefPubMedGoogle Scholar
  • 41 McLean N, Tighiouart M, Muller S. Primary mucosal melanoma of the head and neck. Comparison of clinical presentation and histopathologic features of oral and sinonasal melanoma. Oral Oncol 2008; 44 (11) 1039-1046
    CrossrefPubMedGoogle Scholar
  • 42 Patel SG, Prasad ML, Escrig M , et al. Primary mucosal malignant melanoma of the head and neck. Head Neck 2002; 24 (3) 247-257
    CrossrefPubMedGoogle Scholar
  • 43 Medina JE, Ferlito A, Pellitteri PK , et al. Current management of mucosal melanoma of the head and neck. J Surg Oncol 2003; 83 (2) 116-122
    CrossrefPubMedGoogle Scholar
  • 44 Penel N, Mallet Y, Mirabel X, Van JT, Lefebvre JL. Primary mucosal melanoma of head and neck: prognostic value of clear margins. Laryngoscope 2006; 116 (6) 993-995
    PubMedGoogle Scholar
  • 45 Temam S, Mamelle G, Marandas P , et al. Postoperative radiotherapy for primary mucosal melanoma of the head and neck. Cancer 2005; 103 (2, Issue 2) 313-319
    CrossrefPubMedGoogle Scholar
  • 46 Krengli M, Masini L, Kaanders JH , et al. Radiotherapy in the treatment of mucosal melanoma of the upper aerodigestive tract: analysis of 74 cases. A Rare Cancer Network study. Int J Radiat Oncol Biol Phys 2006; 65 (3) 751-759
    CrossrefPubMedGoogle Scholar
  • 47 Owens JM, Roberts DB, Myers JN. The role of postoperative adjuvant radiation therapy in the treatment of mucosal melanomas of the head and neck region. Arch Otolaryngol Head Neck Surg 2003; 129 (8) 864-868
    CrossrefPubMedGoogle Scholar
  • 48 Ives NJ, Stowe RL, Lorigan P, Wheatley K. Chemotherapy compared with biochemotherapy for the treatment of metastatic melanoma: a meta-analysis of 18 trials involving 2,621 patients. J Clin Oncol 2007; 25 (34) 5426-5434
    CrossrefPubMedGoogle Scholar
  • 49 Bartell HL, Bedikian AY, Papadopoulos NE , et al. Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck 2008; 30 (12) 1592-1598
    CrossrefPubMedGoogle Scholar