Outcomes in patients with mucosal melanomas. Issue 8 (16th October 2013)

• Record Type: Journal Article
• Authors: Keller, Deborah S.; Thomay, Alan A.; Gaughan, John; Olszanski, Anthony; Wu, Hong; Berger, Adam C.; Farma, Jeffrey M.
• Is Part Of: Journal of surgical oncology. Volume 108:Issue 8(2013:Dec. 15)
• Page Start: 516
• Page End: 520
• Publication Date: 2013-10-16
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23445
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="jso23445-sec-0001" sec-type="section"> <title>Background and Objective</title> <p>Our goal was to evaluate the different subtypes of mucosal melanoma and describe specific variables that predict outcomes.</p> </sec> <sec id="jso23445-sec-0002" sec-type="section"> <title>Methods</title> <p>Prospective review of two tertiary care center databases identified 76 mucosal melanoma patients; 73 with complete records were included. Demographic and clinical data were analyzed. Cox regression determined variables impacting recurrence and survival.</p> </sec> <sec id="jso23445-sec-0003" sec-type="section"> <title>Results</title> <p>In the 73 patients, the mean age was 64 years, and 74% were female. Sixty‐seven percent presented with lymph node involvement, and 73% had ulcerated tumors. Major sites affected were nasal/palate/oral (36%), vulvar/vaginal/cervical (48%), and anorectal (15%). Mean overall and disease‐free survival were 56.9 and 27.2 months. Variables associated with decreased survival included: lymphovascular invasion (HR17.70, <italic>P</italic> = 0.0093), Caucasian race (HR3.02, <italic>P</italic> = 0.0362), nasal/palate/oral sub‐group (HR1.85, <italic>P</italic> = 0.026), Breslow thickness (HR1.23, <italic>P</italic> = 0.00004), T stage (HR1.34, <italic>P</italic> = 0.0075), M stage (HR3.03, <italic>P</italic> = 0.0039), and chemotherapy (HR3.13, <italic>P</italic> = 0.0002). The worst prognosis was seen in the nasal/palate/oral sub‐group, with a median overall survival of 9.7 months and recurrence‐free time of 4.5 months. This subtype also demonstrated high lymph node positivity, ulceration, and larger tumor size.</p> </sec> <sec id="jso23445-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The nasal, palate, oral subtype has the worst prognosis compared to other mucosal melanoma locations. Studies are ongoing to evaluate pathologic and genomic variables that may predict outcomes. <italic>J. Surg. Oncol. 2013; 108:516–520</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>