Download PDF
J Neurol Surg B Skull Base 2024; 85(04): 332-339
DOI: 10.1055/s-0043-1769928
Original Article

Impact of Treatment Delay in Head and Neck Mucosal Melanoma on Overall Patient Survival

Elaine C. Martin 
1   Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, United States
,
Arash Abiri
1   Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, United States
,
Kotaro Tsutsumi
1   Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, United States
,
Khodayar Goshtasbi
1   Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, United States
,
Sina J. Torabi
1   Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, United States
,
Edward C. Kuan
1   Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Orange, California, United States
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objectives Head and neck mucosal melanoma (HNMM) is a rare malignancy with high mortality. This study evaluates the impact of treatment delays on overall survival in HNMM.

Design/Setting/Participants A retrospective review of patients with surgically managed HNMM treated with adjuvant radiation was performed from the 2004–2016 National Cancer Database.

Main Outcome Measures Durations of diagnosis-to-treatment initiation (DTI), surgery-to-radiotherapy initiation (SRT), duration of radiotherapy (RTD), surgery-to-immunotherapy initiation (SIT), diagnosis-to-treatment end (DTE), and total treatment package (TTP) were calculated.

Results A total of 1,011 patients (50.7% female, 90.5% Caucasian) met inclusion criteria. Median DTI, SRT, RTD, SIT, DTE, and TTP were 30, 49, 41, 102, 119, and 87 days, respectively. Only longer DTE was associated with decreased mortality (hazard ratio, 0.720; 95% confidence interval, 0.536–0.965; p = 0.028).

Conclusion DTI, SRT, RTD, SIT, and TTP do not significantly affect overall survival in patients with HNMM who undergo surgery and adjuvant radiation. Longer DTE is associated with improved survival in this population.

Level of Evidence 4.

Keywords

mucosal melanoma - treatment delay - survival - head and neck cancer - sinonasal cancer

Previous Presentation

Portions of this work were presented at the 2022 Triological Society Meeting in Coronado, CA, United States.




Publication History

Received: 07 February 2023

Accepted: 08 May 2023

Article published online:
12 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 McLaughlin CC, Wu X-C, Jemal A, Martin HJ, Roche LM, Chen VW. Incidence of noncutaneous melanomas in the U.S. Cancer 2005; 103 (05) 1000-1007
    CrossrefPubMedGoogle Scholar
  • 2 Marcus DM, Marcus RP, Prabhu RS. et al. Rising incidence of mucosal melanoma of the head and neck in the United States. J Skin Cancer 2012; 2012: 231693
    CrossrefPubMedGoogle Scholar
  • 3 Chiu NT, Weinstock MA. Melanoma of oronasal mucosa. Population-based analysis of occurrence and mortality. Arch Otolaryngol Head Neck Surg 1996; 122 (09) 985-988
    CrossrefPubMedGoogle Scholar
  • 4 Mihajlovic M, Vlajkovic S, Jovanovic P, Stefanovic V. Primary mucosal melanomas: a comprehensive review. Int J Clin Exp Pathol 2012; 5 (08) 739-753
    PubMedGoogle Scholar
  • 5 Jethanamest D, Vila PM, Sikora AG, Morris LG. Predictors of survival in mucosal melanoma of the head and neck. Ann Surg Oncol 2011; 18 (10) 2748-2756
    CrossrefPubMedGoogle Scholar
  • 6 Gilain L, Houette A, Montalban A, Mom T, Saroul N. Mucosal melanoma of the nasal cavity and paranasal sinuses. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131 (06) 365-369
    CrossrefPubMedGoogle Scholar
  • 7 Lawaetz M, Birch-Johansen F, Friis S. et al. Primary mucosal melanoma of the head and neck in Denmark, 1982-2012: demographic and clinical aspects. A retrospective DAHANCA study. Acta Oncol 2016; 55 (08) 1001-1008
    CrossrefPubMedGoogle Scholar
  • 8 Yin GF, Guo W, Chen XH, Liu ZY, Huang ZG. Clinical characteristic and prognostic analyses of 117 cases of head and neck mucosal melanoma [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 53 (09) 668-674
    PubMedGoogle Scholar
  • 9 Gal TJ, Silver N, Huang B. Demographics and treatment trends in sinonasal mucosal melanoma. Laryngoscope 2011; 121 (09) 2026-2033
    CrossrefPubMedGoogle Scholar
  • 10 Chang AE, Karnell LH, Menck HR. The American College of Surgeons Commission on Cancer and the American Cancer Society. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. Cancer 1998; 83 (08) 1664-1678
    CrossrefPubMedGoogle Scholar
  • 11 Moreno MA, Roberts DB, Kupferman ME. et al. Mucosal melanoma of the nose and paranasal sinuses, a contemporary experience from the M. D. Anderson Cancer Center. Cancer 2010; 116 (09) 2215-2223
    CrossrefPubMedGoogle Scholar
  • 12 Sahovaler A, Ziai H, Cardemil F. et al. Importance of margins, radiotherapy, and systemic therapy in mucosal melanoma of the head and neck. Laryngoscope 2021; 131 (10) 2269-2276
    CrossrefPubMedGoogle Scholar
  • 13 Elsamna ST, Ahsanuddin S, Mir GS. et al. Surgical margin status and survival following resection of sinonasal mucosal melanoma. Laryngoscope 2021; 131 (11) 2429-2435
    CrossrefPubMedGoogle Scholar
  • 14 Yamazaki N, Takenouchi T, Fujimoto M. et al. Phase 1b study of pembrolizumab (MK-3475; anti-PD-1 monoclonal antibody) in Japanese patients with advanced melanoma (KEYNOTE-041). Cancer Chemother Pharmacol 2017; 79 (04) 651-660
    CrossrefPubMedGoogle Scholar
  • 15 Li S, Wu X, Yan X. et al. Toripalimab plus axitinib in patients with metastatic mucosal melanoma: 3-year survival update and biomarker analysis. J Immunother Cancer 2022; 10 (02) e004036
    CrossrefPubMedGoogle Scholar
  • 16 Nathan P, Ascierto PA, Haanen J. et al. Safety and efficacy of nivolumab in patients with rare melanoma subtypes who progressed on or after ipilimumab treatment: a single-arm, open-label, phase II study (CheckMate 172). Eur J Cancer 2019; 119: 168-178
    CrossrefPubMedGoogle Scholar
  • 17 Xiong DD, Barriera-Silvestrini P, Knackstedt TJ. Delays in the surgical treatment of melanoma are associated with worsened overall and melanoma-specific mortality: a population-based analysis. J Am Acad Dermatol 2022; 87 (04) 807-814
    CrossrefPubMedGoogle Scholar
  • 18 Morse E, Fujiwara RJT, Judson B, Mehra S. Treatment delays in laryngeal squamous cell carcinoma: a national cancer database analysis. Laryngoscope 2018; 128 (12) 2751-2758
    CrossrefPubMedGoogle Scholar
  • 19 Morse E, Berson E, Fujiwara R, Judson B, Mehra S. Hypopharyngeal cancer treatment delays: benchmarks and survival association. Otolaryngol Head Neck Surg 2019; 160 (02) 267-276
    CrossrefPubMedGoogle Scholar
  • 20 Goel AN, Lee JT, Wang MB, Suh JD. Treatment delays in surgically managed sinonasal cancer and association with survival. Laryngoscope 2020; 130 (01) 2-11
    CrossrefPubMedGoogle Scholar
  • 21 Tsutsumi K, Ahmed KH, Goshtasbi K. et al. Impact of esthesioneuroblastoma treatment delays on overall patient survival. Laryngoscope 2023; 133 (04) 764-772
    CrossrefPubMedGoogle Scholar
  • 22 Qatanani AM, Eide JG, Harris JC. et al. The impact of delay in treatment on survival in surgically managed sinonasal undifferentiated carcinoma. J Neurol Surg B Skull Base 2023; 84 (04) 320-328
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Boffa DJ, Rosen JE, Mallin K. et al. Using the national cancer database for outcomes research a review. JAMA Oncol 2017; 3 (12) 1722-1728
    CrossrefPubMedGoogle Scholar
  • 24 Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992; 45 (06) 613-619
    CrossrefPubMedGoogle Scholar
  • 25 Gore MR, Zanation AM. Survival in sinonasal melanoma: a meta-analysis. J Neurol Surg B Skull Base 2012; 73 (03) 157-162
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Temam S, Mamelle G, Marandas P. et al. Postoperative radiotherapy for primary mucosal melanoma of the head and neck. Cancer 2005; 103 (02) 313-319
    CrossrefPubMedGoogle Scholar
  • 27 Owens JM, Roberts DB, Myers JN. The role of postoperative adjuvant radiation therapy in the treatment of mucosal melanomas of the head and neck region. Arch Otolaryngol Head Neck Surg 2003; 129 (08) 864-868
    CrossrefPubMedGoogle Scholar
  • 28 Benlyazid A, Thariat J, Temam S. et al. Postoperative radiotherapy in head and neck mucosal melanoma: a GETTEC study. Arch Otolaryngol Head Neck Surg 2010; 136 (12) 1219-1225
    CrossrefPubMedGoogle Scholar
  • 29 Wushou A, Hou J, Zhao YJ, Miao XC. Postoperative adjuvant radiotherapy improves loco-regional recurrence of head and neck mucosal melanoma. J Craniomaxillofac Surg 2015; 43 (04) 553-558
    CrossrefPubMedGoogle Scholar
  • 30 Jarrom D, Paleri V, Kerawala C. et al. Mucosal melanoma of the upper airways tract mucosal melanoma: a systematic review with meta-analyses of treatment. Head Neck 2017; 39 (04) 819-825
    CrossrefPubMedGoogle Scholar