Title: Pigmentation status as a Prognostic Biomarker for Survival in Mucosal Melanoma

Background Mucosal melanoma (MM) is a rare, aggressive subtype of melanoma with limited therapeutic options and a dismal clinical outcome. Systemic treatments and predictive biomarkers for MM are missing and the gold standard is complete surgical resection. Diagnosis can be challenging, especially when pigmentation in suspicious lesions is absent. The prognostic value of pigmentation in MM has not been assessed.

Methods First, we ran a source query and only included patients with the diagnosis of MM and clinical information. Furthermore, we performed clinically integrated molecular genotyping. Pigmentation status was assessed by review of slides or pathological reports. Treatment regimens were identified by chart review.

Results We identified 39 patients with MM. Patients with amelanotic MM had significantly worse overall survival (p = 0.002). In addition, the presence of NRAS or KRAS mutations was significantly associated with poor overall survival (p<0.001). Immunotherapy did not show a survival benefit for patients.

Conclusions We coupled comprehensive clinical and molecular data of MM patients with therapeutic treatment decisions and survival data and determined the prognostic value of pigmentation in MM. Here, we identified pigmentation status as a novel prognostic biomarker that will emphasize the importance of full clinical workup in suspicious melanocytic lesions of the mucosa.

Publication History

Article published online:
12 May 2023