Oncologic outcomes, prognostic factor analysis and therapeutic algorithm evaluation of head and neck mucosal melanomas in France.
Adult
Aged
Aged, 80 and over
Algorithms
Female
France
Head and Neck Neoplasms
/ mortality
Humans
Male
Melanoma
/ mortality
Middle Aged
Mouth Mucosa
/ pathology
Mouth Neoplasms
/ mortality
Nasal Mucosa
/ pathology
Neoplasm Staging
Nose Neoplasms
/ mortality
Otorhinolaryngologic Surgical Procedures
Paranasal Sinus Neoplasms
/ mortality
Paranasal Sinuses
/ pathology
Prognosis
Progression-Free Survival
Prospective Studies
Radiotherapy, Adjuvant
Survival Rate
Tumor Burden
Young Adult
Head and neck
Mucosal melanoma
Oral cavity
Prognosis
Radiotherapy
Sinonasal
Journal
European journal of cancer (Oxford, England : 1990)
ISSN: 1879-0852
Titre abrégé: Eur J Cancer
Pays: England
ID NLM: 9005373
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
11
02
2019
revised:
03
05
2019
accepted:
10
09
2019
pubmed:
2
11
2019
medline:
17
6
2020
entrez:
1
11
2019
Statut:
ppublish
Résumé
Head and neck mucosal melanoma (HNMM) is aggressive and rare, with a poor prognosis because of its high metastatic potential. The two main subtypes are sinonasal (sinonasal mucosal melanoma [SNMM]) and oral cavity (oral cavity mucosal melanoma [OCMM]). Consensual therapeutic guidelines considering the primary tumour site and tumour-node-metastasis (TNM) stage are not well established. Patients with HNMM from the prospective national French Rare Head and Neck Cancer Expert Network database between 2000 and 2017 were included. Clinical characteristics, treatment modalities, outcomes and prognostic factors were analysed. In total, 314 patients were included. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 49.4% and 24.7%, respectively, in the surgery group; no long-term survivors were observed when surgery was not feasible. Moreover, even after surgery, a high recurrence rate was reported with a median PFS of 22 months. In multivariate analysis, Union for International Cancer Control (UICC) stage and tumour site correlated with PFS and OS. Postoperative radiotherapy (PORT) improved the PFS but not OS in patients with small (T3) SNMM and OCMM tumours. Nodal involvement was more frequent in patients with OCMM (p < 10 Even early HNMM was associated with poor oncologic outcomes due to distant metastases despite surgical resection with clear margins. Lymph node metastases had no impact on the prognosis, suggesting treatment de-escalation in cervical node management. PORT might be useful for local control.
Sections du résumé
BACKGROUND
Head and neck mucosal melanoma (HNMM) is aggressive and rare, with a poor prognosis because of its high metastatic potential. The two main subtypes are sinonasal (sinonasal mucosal melanoma [SNMM]) and oral cavity (oral cavity mucosal melanoma [OCMM]). Consensual therapeutic guidelines considering the primary tumour site and tumour-node-metastasis (TNM) stage are not well established.
MATERIAL & METHODS
Patients with HNMM from the prospective national French Rare Head and Neck Cancer Expert Network database between 2000 and 2017 were included. Clinical characteristics, treatment modalities, outcomes and prognostic factors were analysed.
RESULTS
In total, 314 patients were included. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 49.4% and 24.7%, respectively, in the surgery group; no long-term survivors were observed when surgery was not feasible. Moreover, even after surgery, a high recurrence rate was reported with a median PFS of 22 months. In multivariate analysis, Union for International Cancer Control (UICC) stage and tumour site correlated with PFS and OS. Postoperative radiotherapy (PORT) improved the PFS but not OS in patients with small (T3) SNMM and OCMM tumours. Nodal involvement was more frequent in patients with OCMM (p < 10
CONCLUSION
Even early HNMM was associated with poor oncologic outcomes due to distant metastases despite surgical resection with clear margins. Lymph node metastases had no impact on the prognosis, suggesting treatment de-escalation in cervical node management. PORT might be useful for local control.
Identifiants
pubmed: 31670075
pii: S0959-8049(19)30729-4
doi: 10.1016/j.ejca.2019.09.007
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1-10Investigateurs
S Albert
(S)
G Andry
(G)
E Babin
(E)
C Bach
(C)
J-M Badet
(JM)
C Badoual
(C)
A C Baglin
(AC)
A Banal
(A)
B Barry
(B)
E Baudin
(E)
B Baujat
(B)
R J Bensadoun
(RJ)
C Bertolus
(C)
J-P Bessède
(JP)
D Blanchard
(D)
C Borel
(C)
A Bozorg-Grayeli
(A)
R Breheret
(R)
P Breton
(P)
L Brugel
(L)
G Calais
(G)
O Casiraghi
(O)
E Cassagnau
(E)
L Castillo
(L)
P Ceruse
(P)
F Chabolle
(F)
D Chevalier
(D)
J C Chobaut
(JC)
O Choussy
(O)
A Cosmidis
(A)
A Coste
(A)
V Costes
(V)
L Crampette
(L)
V Darrouzet
(V)
P Demez
(P)
P Dessi
(P)
B Devauchelle
(B)
L Digue
(L)
G Dolivet
(G)
F Dubrulle
(F)
S Duflo
(S)
X Dufour
(X)
C Even
(C)
S Faivre
(S)
N Fakhry
(N)
C Ferron
(C)
F Floret
(F)
L de Gabory
(L)
R Garrel
(R)
L Geoffrois
(L)
L Gilain
(L)
A Giovanni
(A)
A Girod
(A)
B Guerrier
(B)
S Hans
(S)
P Herman
(P)
P Hofman
(P)
M Housset
(M)
R Jankowski
(R)
F Jegoux
(F)
M Juliéron
(M)
M-C Kaminsky
(MC)
F Kolb
(F)
J Lacau St Guily
(J)
L Laccoureye
(L)
B Lallemant
(B)
P Lang
(P)
E Lartigau
(E)
J-P Lavieille
(JP)
M Lefevre
(M)
X Leroy
(X)
O Malard
(O)
F Massip
(F)
O Mauvais
(O)
J-C Merol
(JC)
J Michel
(J)
T Mom
(T)
S Morinière
(S)
E de Monès
(E)
G Moulin
(G)
A Moya-Plana
(A)
G Noel
(G)
G Poissonnet
(G)
J-M Prades
(JM)
D de Raucourt
(D)
E Reyt
(E)
C Righini
(C)
Y Marie Robin
(Y)
F Rolland
(F)
B Ruhin
(B)
N Sarroul
(N)
P Schultz
(P)
E Serrano
(E)
O Sterkers
(O)
V Strunski
(V)
A Sudaka
(A)
M Tassart
(M)
S Testelin
(S)
J Thariat
(J)
A Timochenko
(A)
B Toussaint
(B)
E Uro Coste
(E)
G Valette
(G)
T Van den Abbeele
(T)
A Varoquaux
(A)
F Veillon
(F)
S Vergez
(S)
B Vérillaud
(B)
M Wassef
(M)
Informations de copyright
Copyright © 2019 Elsevier Ltd. All rights reserved.