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Effects of Lymph Node Metastasis in Patients with Mucosal Melanoma
What are the effects of lymph node metastasis on survival in patients with mucosal melanoma in the head and neck?
Mucosal melanomas in the head and neck region are most often located in the nasal cavity and paranasal sinuses. The prognostic effects of lymph node metastasis in patients with sinonasal mucosal melanoma have not been established. A recent study sought to determine the effects of lymph node metastasis on survival.
The study included 198 patients with sinonasal mucosal melanoma who had been treated between 1985 and 2016 at The University of Texas MD Anderson Cancer Center in Houston. Patients’ clinical and pathologic lymph node statuses were evaluated and characterised. A multivariate analysis was used to assess the associations between regional spread and survival outcomes.
Therapeutic neck dissection was performed in 23 patients with sinonasal mucosal melanoma (11.6 per cent). Regional disease recurrence occurred in seven of the patients who had lymph node metastasis at the time of presentation (30.4 per cent) and in 30 of those who had N0 disease at the time of presentation (17.1 per cent).
Metastasis to the contralateral lymph nodes was present in seven patients (3.5 per cent). The five‐year disease‐specific survival rate was 66 per cent in patients with lymph node spread compared with 45 per cent in patients with N0 status.
A multivariate analysis demonstrated that distant metastasis was the only variable found to be independently associated with both overall survival and disease‐specific survival.
The study results demonstrated that lymph node status in patients with sinonasal mucosal melanoma was not a significant predictor of outcome. This finding, together with the low incidence of lymph node metastases in patients with sinonasal mucosal melanoma, suggests that elective treatment of the neck should be highly selective in this patient population.
Amit, M. , Tam, S. , Abdelmeguid, A. S., Roberts, D. B., Raza, S. M., Su, S. Y., Kupferman, M. E., DeMonte, F. and Hanna, E. Y. (2018), Approaches to regional lymph node metastasis in patients with head and neck mucosal melanoma. Cancer, 124: 514-520. doi:10.1002/cncr.31083
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