Mucosal Melanoma of the Head and Neck: Tata Memorial Hospital Experience
Vedang Murthy, Ashwini Budrukkar, Gupta Tejpal, Jai Prakash Agarwal, Suruchi Singh, Sarbani Ghosh-Laskar, Shubhda Kane, Anil K D'Cruz
Citation Information :
Murthy V, Budrukkar A, Tejpal G, Agarwal JP, Singh S, Ghosh-Laskar S, Kane S, D'Cruz AK. Mucosal Melanoma of the Head and Neck: Tata Memorial Hospital Experience. Int J Head Neck Surg 2010; 1 (3):141-145.
Primary mucosal melanoma of the head and neck (MMHN) is a rare, aggressive tumor of neural-crest origin. Despite universal progress in cancer care, the prognosis of MMHN continues to remain dismal.
Aims
To analyze and report the outcomes of primary head and neck mucosal melanomas treated at Tata Memorial Hospital.
Methods
Retrospective chart review of all patients with a diagnosis of nonocular MMHN presenting to the institute between 1995 to 2003. Locoregional control and disease-free survival were used as outcome measures.
Results
42 patients presenting within the study period with nonocular MMHN (oral-55%, sinonasal-40%, and pharyngeal-5%) at a median age of 53 years constituted the demographic cohort. 11 (26%) patients not amenable to any active anticancer treatment were treated with best supportive care alone and excluded from outcome analysis. 26 patients underwent surgery with complete resection of tumor. Seven (27%) also received adjuvant radiotherapy due to the adverse histopathologic features. Two patients were treated with radical radiotherapy due to unresectability, two patients received palliative chemotherapy, while one patient was treated with definitive chemoradiotherapy. With a mean follow-up of 11 months (range 1-58 months), the 3-year locoregional control and disease-free survival was 41% and 12% respectively. Age, sex, site of primary, tumor stage, surgical resection, margin status, depth of infiltration, and adjuvant radiotherapy did not affect outcome significantly.
Conclusion
Primary mucosal melanoma of the head and neck is a rare, but, aggressive tumor with a dismal prognosis. Surgical resection with clear margins offers the best chance of cure for early localized disease. The high incidence of locoregional as well as distant failures after surgical resection supports the use of adjuvant therapy. Deeper insights into the pathobiology of disease can help develop more specific and effective treatment strategies to improve long-term outcomes.
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