Survival in Sinonasal Melanoma: A Meta-analysis

Mitchell R. Gore; Adam M. Zanation

doi:10.1055/s-0032-1301400

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2012; 73(03): 157-162
DOI: 10.1055/s-0032-1301400

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Survival in Sinonasal Melanoma: A Meta-analysis

Mitchell R. Gore

¹Division of Skull Base Surgery/Rhinology, Department of Otolaryngology–Head and Neck Surgery, UNC-Chapel Hill School of Medicine, Chapel Hill, North Carolina

,

Adam M. Zanation

¹Division of Skull Base Surgery/Rhinology, Department of Otolaryngology–Head and Neck Surgery, UNC-Chapel Hill School of Medicine, Chapel Hill, North Carolina

› Author Affiliations

Abstract

Sinonasal melanoma is an uncommon tumor which carries a poor prognosis and high rates of local and regional recurrence and distant metastasis. While surgical resection is the mainstay of treatment, the utility of multimodality therapy has not been well studied or established. We sought to better evaluate the optimal treatment modality for sinonasal melanoma. We reviewed 39 case reports involving 423 patients with sinonasal melanoma and present a meta-analysis comparing survival by treatment modality. The two-tailed p-value for survival by treatment modality was determined. The number of primary site/local, regional, and distant recurrences was determined where data was available. There was a nonsignificant increase in survival for patients treated with surgery + radiotherapy versus surgery alone. There was a statistically significant increase in survival for surgery + chemotherapy versus chemotherapy alone and versus surgery alone. Patients treated with combined surgery, radiation, and chemotherapy had a statistically shorter survival interval than patients treated with surgery + chemotherapy, which may reflect more advanced disease in patients treated with triple therapy. There was no statistically significant increase in survival found for the addition of radiation to surgery. This meta-analysis demonstrates that multimodality therapy, particularly the addition of chemo-or immunotherapy to surgery, may increase survival in a subset of patients. Radiation therapy did not appear to increase survival. There may be a significant increase in overall survival with combined modality therapy with surgery and chemo/immunotherapy versus single modality therapy. Level of evidence: III. Grade of recommendation: C.

Keywords

sinonasal - melanoma - skull base - endoscopic

Full Text

References

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