Predictors of survival in head and neck mucosal melanoma
•This is the largest study of head and neck mucosal melanomas to date.•Prognosis remains poor with a 27.9% 5-year overall survival.•Paranasal sinus tumors have worse prognosis than other head and neck sites.•Surgery with or without radiation has better survival than non-surgical approaches.•There ha...
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| Veröffentlicht in: | Oral oncology 2017-10, Vol.73, p.36-42 |
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| creator | Schmidt, Matthew Q. David, John Yoshida, Emi J. Scher, Kevin Mita, Alain Shiao, Stephen L. Ho, Allen S. Zumsteg, Zachary S. |
| description | •This is the largest study of head and neck mucosal melanomas to date.•Prognosis remains poor with a 27.9% 5-year overall survival.•Paranasal sinus tumors have worse prognosis than other head and neck sites.•Surgery with or without radiation has better survival than non-surgical approaches.•There has been increased use of multi-modality treatment over the last decade.
To evaluate hospital-based data of head and neck mucosal melanoma patients in order to identify predictors of survival.
The National Cancer Data Base was used to identify 1368 patients with head and neck mucosal melanoma diagnosed between the years of 2004 and 2012. The Kaplan-Meier method was utilized to estimate overall survival, and multivariate Cox regression analyses were performed to assess the impact of covariates on survival after adjusting for confounding variables.
Median follow-up was 55.2months. Median survival of all patients was 29.3months, and the 5-year survival was 27.4%. After adjusting for other prognostic factors in multivariate analysis, paranasal sinus location [hazard ratio (HR)=1.54, 95% Confidence Interval (CI)=1.30–1.82, P |
| doi_str_mv | 10.1016/j.oraloncology.2017.08.002 |
| format | Article |
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To evaluate hospital-based data of head and neck mucosal melanoma patients in order to identify predictors of survival.
The National Cancer Data Base was used to identify 1368 patients with head and neck mucosal melanoma diagnosed between the years of 2004 and 2012. The Kaplan-Meier method was utilized to estimate overall survival, and multivariate Cox regression analyses were performed to assess the impact of covariates on survival after adjusting for confounding variables.
Median follow-up was 55.2months. Median survival of all patients was 29.3months, and the 5-year survival was 27.4%. After adjusting for other prognostic factors in multivariate analysis, paranasal sinus location [hazard ratio (HR)=1.54, 95% Confidence Interval (CI)=1.30–1.82, P<0.001)] and the use of radiotherapy alone for definitive local treatment (HR=2.27, 95% CI=1.72–2.98, P<0.001) were associated with worse survival. Similar results were seen in the subgroup of patients with complete clinical staging information. In terms of patterns of care, the use of combined surgery and radiotherapy as the primary local treatment modality has significant increased from 2004 and 2012 (P=0.03).
Outcomes in mucosal melanoma of the head and neck remain suboptimal, despite increased use of multimodality local therapy, likely due to the high risk of distant metastases. Mucosal melanomas arising from the paranasal sinuses have particularly poor prognosis. Novel therapeutic paradigms for head and neck mucosal melanoma, incorporating systemic therapies to decrease the risk of distant relapse, should be pursued in clinical trials.</description><identifier>ISSN: 1368-8375</identifier><identifier>EISSN: 1879-0593</identifier><identifier>DOI: 10.1016/j.oraloncology.2017.08.002</identifier><identifier>PMID: 28939074</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Demographics ; Female ; Head and neck cancer ; Head and Neck Neoplasms - pathology ; Head and Neck Neoplasms - therapy ; Humans ; Male ; Melanoma ; Melanoma - pathology ; Melanoma - therapy ; Middle Aged ; Mucous Membrane - pathology ; Nasal cancer ; Nasopharynx cancer ; Oral cancer ; Paranasal sinus cancer ; Prognosis ; Survival Analysis ; Young Adult</subject><ispartof>Oral oncology, 2017-10, Vol.73, p.36-42</ispartof><rights>2017 Elsevier Ltd</rights><rights>Copyright © 2017 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-4c0b1cb6638ee21c24f1d86987b8817b084036137c60a1b31260de52d94ad1713</citedby><cites>FETCH-LOGICAL-c446t-4c0b1cb6638ee21c24f1d86987b8817b084036137c60a1b31260de52d94ad1713</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1368837517302361$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28939074$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schmidt, Matthew Q.</creatorcontrib><creatorcontrib>David, John</creatorcontrib><creatorcontrib>Yoshida, Emi J.</creatorcontrib><creatorcontrib>Scher, Kevin</creatorcontrib><creatorcontrib>Mita, Alain</creatorcontrib><creatorcontrib>Shiao, Stephen L.</creatorcontrib><creatorcontrib>Ho, Allen S.</creatorcontrib><creatorcontrib>Zumsteg, Zachary S.</creatorcontrib><title>Predictors of survival in head and neck mucosal melanoma</title><title>Oral oncology</title><addtitle>Oral Oncol</addtitle><description>•This is the largest study of head and neck mucosal melanomas to date.•Prognosis remains poor with a 27.9% 5-year overall survival.•Paranasal sinus tumors have worse prognosis than other head and neck sites.•Surgery with or without radiation has better survival than non-surgical approaches.•There has been increased use of multi-modality treatment over the last decade.
To evaluate hospital-based data of head and neck mucosal melanoma patients in order to identify predictors of survival.
The National Cancer Data Base was used to identify 1368 patients with head and neck mucosal melanoma diagnosed between the years of 2004 and 2012. The Kaplan-Meier method was utilized to estimate overall survival, and multivariate Cox regression analyses were performed to assess the impact of covariates on survival after adjusting for confounding variables.
Median follow-up was 55.2months. Median survival of all patients was 29.3months, and the 5-year survival was 27.4%. After adjusting for other prognostic factors in multivariate analysis, paranasal sinus location [hazard ratio (HR)=1.54, 95% Confidence Interval (CI)=1.30–1.82, P<0.001)] and the use of radiotherapy alone for definitive local treatment (HR=2.27, 95% CI=1.72–2.98, P<0.001) were associated with worse survival. Similar results were seen in the subgroup of patients with complete clinical staging information. In terms of patterns of care, the use of combined surgery and radiotherapy as the primary local treatment modality has significant increased from 2004 and 2012 (P=0.03).
Outcomes in mucosal melanoma of the head and neck remain suboptimal, despite increased use of multimodality local therapy, likely due to the high risk of distant metastases. Mucosal melanomas arising from the paranasal sinuses have particularly poor prognosis. Novel therapeutic paradigms for head and neck mucosal melanoma, incorporating systemic therapies to decrease the risk of distant relapse, should be pursued in clinical trials.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Combined Modality Therapy</subject><subject>Demographics</subject><subject>Female</subject><subject>Head and neck cancer</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Head and Neck Neoplasms - therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Melanoma</subject><subject>Melanoma - pathology</subject><subject>Melanoma - therapy</subject><subject>Middle Aged</subject><subject>Mucous Membrane - pathology</subject><subject>Nasal cancer</subject><subject>Nasopharynx cancer</subject><subject>Oral cancer</subject><subject>Paranasal sinus cancer</subject><subject>Prognosis</subject><subject>Survival Analysis</subject><subject>Young Adult</subject><issn>1368-8375</issn><issn>1879-0593</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEtP3TAQha2qVXn-BRSxYpMwEzt-sEO0BSQkumjXlmPPhVySmNo3V-Lf1-hSxLKrGWnOmTPzMXaK0CCgPF83Mbkxzj6O8eGlaQFVA7oBaD-xfdTK1NAZ_rn0XOpac9XtsYOc1wDQYQdf2V6rDTegxD7TPxOFwW9iylVcVXlJ22HrxmqYq0dyoXJzqGbyT9W0-JjLYKLRzXFyR-zLyo2Zjt_qIfv94_uvq5v67v769uryrvZCyE0tPPToeym5JmrRt2KFQUujVa81qh60AC6RKy_BYc-xlRCoa4MRLqBCfsjOdnufU_yzUN7YaciexnIFxSVbNKKVRhqhivRiJ_Up5pxoZZ_TMLn0YhHsKzm7th_J2VdyFrQt5Ir55C1n6ScK79Z_qIrg205A5dvtQMlmP9DsC75EfmNDHP4n5y_jnoUT</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Schmidt, Matthew Q.</creator><creator>David, John</creator><creator>Yoshida, Emi J.</creator><creator>Scher, Kevin</creator><creator>Mita, Alain</creator><creator>Shiao, Stephen L.</creator><creator>Ho, Allen S.</creator><creator>Zumsteg, Zachary S.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201710</creationdate><title>Predictors of survival in head and neck mucosal melanoma</title><author>Schmidt, Matthew Q. ; David, John ; Yoshida, Emi J. ; Scher, Kevin ; Mita, Alain ; Shiao, Stephen L. ; Ho, Allen S. ; Zumsteg, Zachary S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-4c0b1cb6638ee21c24f1d86987b8817b084036137c60a1b31260de52d94ad1713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Combined Modality Therapy</topic><topic>Demographics</topic><topic>Female</topic><topic>Head and neck cancer</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Head and Neck Neoplasms - therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Melanoma</topic><topic>Melanoma - pathology</topic><topic>Melanoma - therapy</topic><topic>Middle Aged</topic><topic>Mucous Membrane - pathology</topic><topic>Nasal cancer</topic><topic>Nasopharynx cancer</topic><topic>Oral cancer</topic><topic>Paranasal sinus cancer</topic><topic>Prognosis</topic><topic>Survival Analysis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schmidt, Matthew Q.</creatorcontrib><creatorcontrib>David, John</creatorcontrib><creatorcontrib>Yoshida, Emi J.</creatorcontrib><creatorcontrib>Scher, Kevin</creatorcontrib><creatorcontrib>Mita, Alain</creatorcontrib><creatorcontrib>Shiao, Stephen L.</creatorcontrib><creatorcontrib>Ho, Allen S.</creatorcontrib><creatorcontrib>Zumsteg, Zachary S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Oral oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schmidt, Matthew Q.</au><au>David, John</au><au>Yoshida, Emi J.</au><au>Scher, Kevin</au><au>Mita, Alain</au><au>Shiao, Stephen L.</au><au>Ho, Allen S.</au><au>Zumsteg, Zachary S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of survival in head and neck mucosal melanoma</atitle><jtitle>Oral oncology</jtitle><addtitle>Oral Oncol</addtitle><date>2017-10</date><risdate>2017</risdate><volume>73</volume><spage>36</spage><epage>42</epage><pages>36-42</pages><issn>1368-8375</issn><eissn>1879-0593</eissn><abstract>•This is the largest study of head and neck mucosal melanomas to date.•Prognosis remains poor with a 27.9% 5-year overall survival.•Paranasal sinus tumors have worse prognosis than other head and neck sites.•Surgery with or without radiation has better survival than non-surgical approaches.•There has been increased use of multi-modality treatment over the last decade.
To evaluate hospital-based data of head and neck mucosal melanoma patients in order to identify predictors of survival.
The National Cancer Data Base was used to identify 1368 patients with head and neck mucosal melanoma diagnosed between the years of 2004 and 2012. The Kaplan-Meier method was utilized to estimate overall survival, and multivariate Cox regression analyses were performed to assess the impact of covariates on survival after adjusting for confounding variables.
Median follow-up was 55.2months. Median survival of all patients was 29.3months, and the 5-year survival was 27.4%. After adjusting for other prognostic factors in multivariate analysis, paranasal sinus location [hazard ratio (HR)=1.54, 95% Confidence Interval (CI)=1.30–1.82, P<0.001)] and the use of radiotherapy alone for definitive local treatment (HR=2.27, 95% CI=1.72–2.98, P<0.001) were associated with worse survival. Similar results were seen in the subgroup of patients with complete clinical staging information. In terms of patterns of care, the use of combined surgery and radiotherapy as the primary local treatment modality has significant increased from 2004 and 2012 (P=0.03).
Outcomes in mucosal melanoma of the head and neck remain suboptimal, despite increased use of multimodality local therapy, likely due to the high risk of distant metastases. Mucosal melanomas arising from the paranasal sinuses have particularly poor prognosis. Novel therapeutic paradigms for head and neck mucosal melanoma, incorporating systemic therapies to decrease the risk of distant relapse, should be pursued in clinical trials.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>28939074</pmid><doi>10.1016/j.oraloncology.2017.08.002</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Combined Modality Therapy Demographics Female Head and neck cancer Head and Neck Neoplasms - pathology Head and Neck Neoplasms - therapy Humans Male Melanoma Melanoma - pathology Melanoma - therapy Middle Aged Mucous Membrane - pathology Nasal cancer Nasopharynx cancer Oral cancer Paranasal sinus cancer Prognosis Survival Analysis Young Adult |
| title | Predictors of survival in head and neck mucosal melanoma |
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