Outcomes of primary mucosal melanoma originated from sinonasal tract

Purpose Mucosal melanoma of the head and neck is a rare entity with a poor prognosis. Sinonasal tract is a common occurrence site for this malignancy. The aim of this study is to provide an analysis of 25 patients diagnosed with sinonasal mucosal melanoma (SNMM) treated in a single institution. Patients and methods The medical charts of 25 SNMM patients without distant metastasis treated from 1996 to 2007 were reviewed. Patients were re-staged according to the 7th edition of American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system for head and neck melanoma. Fourteen and 11 patients were diagnosed with T3 or T4 disease, respectively. Three patients had lymph node metastasis at diagnosis. Surgical resection was performed in 21 patients (84 %), and adjuvant radiation therapy was given to all patients except for one. Several patients also received chemotherapy or biological treatment. Results The 5-year local-regional control (LRC) rate was 54 %. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 41 and 38 %, respectively. Recurrences were observed in 10 patients and distal failures in 9 cases. On univariate analysis, locally advanced stage (IV) was a poor prognostic factor for OS and DFS ( P < 0.05). In addition, patients diagnosed with T4 lesions had significantly reduced local-regional control as compared to those with T3 diseases (18 vs. 77 %, P = 0.02). Multivariate analysis revealed that T classification was the only significant factor for local-regional control. Conclusion SNMM is a devastating tumor, with high risk for local failure as well as distant metastases. The stage of the primary disease, i.e., the extent of tumor infiltration, is the predominant factor influencing the prognosis. OS and DFS after surgery followed by radiation therapy remain suboptimal. Further researches for novel treatment strategies such as targeted therapy are necessary to improve the outcomes.