Primary Head and Neck Mucosal Melanoma: Predictors of Survival and a Case Series on Sentinel Node Biopsy

Introduction:

Head and neck mucosal melanoma (HNMM) is a rare tumor with a poor outcome. The aim of this study was to assess the outcome and identify prognostic factors for a cohort of patients treated in a single head and neck cancer center. In addition we included a case series on sentinel node biopsy (SLNB) to evaluate its value as a staging tool for the node-negative neck.

Methods:

We chose a retrospective study design and included 50 patients that were treated between 1973 and 2015 at Fachklinik Hornheide for primary HNMM. To estimate survival rates we used the Kaplan-Meier method. Uni- and multivariate analysis were used to study the influence of possible risk factors on patients' outcome. These risk factors included patient demographics, tumor characteristics and treatment modalities.

Results:

All patients were treated surgical and 50% received adjuvant treatment. The median disease specific survival (DSS) was 38 months, with a 5-year survival rate of 30%. Positive surgical margin (p =.004) and distant failure (p =.005) were associated with a worse DSS. The median disease freee survival (DFS) was 27 months with a 5-year disease-free rate of 12%. Only tumor depth > 5 mm (p =.002) was associated with a worse DFS. 5 node-negative patients received SLN-Biopsy, 2 were positive and all developed distant failure. The 3 SLN-negative patients stayed free of distant failure. Radiotherapy and chemotherapy had no influence on any outcome measure. UICC-Stage could not predict survival.

Conclusion:

Positive surgical margin and distant failure are the only independent prognostic factors for DSS. Tumor depth can predict disease recurrence. SLNB may be a valuable staging tool for the node-negative neck but further research is needed.

Publication History

Publication Date:
18 April 2018 (online)