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- Title
Evolving Therapeutic Strategies in Mucosal Melanoma Have Not Improved Survival Over Five Decades.
- Authors
KIRCHOFF, DANIEL D.; DEUTSCH, GARY B.; FOSHAG, LELAND J.; JI HEY LEE; MYUNG-SHIN SIM; FARIES, MARK B.; Lee, Ji Hey; Sim, Myung-Shin
- Abstract
Mucosal melanoma represents a distinct minority of disease sites and portends a worse outcome. The ideal treatment and role of adjuvant therapy remains unknown at this time. We hypothesized that a combination of neoadjuvant and adjuvant therapies would improve survival in these aggressive melanomas. Our large, prospectively maintained melanoma database was queried for all patients diagnosed with mucosal melanoma. Over the past five decades, 227 patients were treated for mucosal melanoma. There were 82 patients with anorectal, 75 with sinonasal, and 70 with urogenital melanoma. Five-year overall survival and melanoma-specific survival for the entire cohort were 32.8 and 37.5 per cent, respectively, with median overall survival of 38.7 months. One hundred forty-two patients (63.8%) underwent adjuvant therapy and 15 were treated neoadjuvantly (6.6%). There was no survival difference by therapy type or timing, disease site, or decade of diagnosis. There was improved survival in patients undergoing multiple surgeries (Hazard Ratio [HR] 0.55, P = 0.0005). Patients receiving neoadjuvant therapy had significantly worse survival outcomes (HR 2.49, P = 0.013). Over the past five decades, improvements have not been seen in outcomes for mucosal melanoma. Although multiple surgical interventions portend a better outcome in patients with mucosal melanoma, adjuvant treatment decisions must be individualized.
- Subjects
MELANOMA treatment; ADJUVANT treatment of cancer; MUCOUS membrane cancer; NASAL mucosa; ORAL mucosa diseases; MELANOMA diagnosis; COMBINED modality therapy; DATABASES; CAUSES of death; GENITOURINARY organ tumors; INTESTINAL mucosa; MELANOMA; MUCOUS membranes; ORAL mucosa; PARANASAL sinus cancer; RECTUM tumors; RESEARCH funding; RESPIRATORY mucosa; RISK assessment; SURVIVAL analysis (Biometry); RETROSPECTIVE studies; KAPLAN-Meier estimator; TUMOR treatment
- Publication
American Surgeon, 2016, Vol 82, Issue 1, p1
- ISSN
0003-1348
- Publication type
journal article
- DOI
10.1177/000313481608200102