J Korean Assoc Oral Maxillofac Surg.  2021 Apr;47(2):76-81. 10.5125/jkaoms.2021.47.2.76.

Primary malignant mucosal melanoma of the maxillofacial area

• Kim H
• Lee S
• Cha IH
• Kim HJ
• Nam W

• KMID: 2515305
• DOI: http://doi.org/10.5125/jkaoms.2021.47.2.76

Abstract

Objectives
We aimed to collect and report data from all patients who have been diagnosed with mucosal malignant melanoma to obtain the epidemiology and principles of current treatments.
Materials and Methods
Between January 2008 and December 2018, 20 patients underwent surgery or follow-up observations at Yonsei University Dental Hospital. The patients’ clinical information was reviewed retrospectively.
Results
Seventeen of 20 patients had undergone definitive surgery, while only 6 patients received adjuvant radiotherapy or systemic therapy. Eight of 20 patients, including those that had recurrent lesions, were provided immunotherapy. The 3-year survival for all stages was 50%, with a local recurrence rate of 75% and a metastasis rate of 65%.
Conclusion
The overall survival of patients receiving surgical treatment was longer than that of patients who did not undergo surgical resection. Eight of 20 patients received immunotherapy as the first-line regimen at our clinic, and those patients exhibited longer overall survival compared to patients in reported keynote studies.

Keyword

Malignant melanoma; Immunotherapy; Oral cancer

Figure

• 

  Fig. 1 Treatment by clinical stage in this study. (Sx: surgery, RTx: radiotherapy, CTx: systemic therapy, CCRT: concurrent chemo-radio therapy)

• 

  Fig. 2 Overall survival rate with survival time in this study.

• 

  Fig. 3 Overall survival rate by clinical stages with survival time in this study (P<0.01).

• 

  Fig. 4 Overall survival rate by treatment with survival time in this study (P=0.128).

Reference

References

1. Andersen LJ, Berthelsen A, Hansen HS. 1992; Malignant melanoma of the upper respiratory tract and the oral cavity. J Otolaryngol. 21:180–5. PMID: 1404568.

2. Chang AE, Karnell LH, Menck HR. 1998; The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 83:1664–78. https://doi.org/10.1002/(sici)1097-0142(19981015)83:8<1664::aid-cncr23>3.0.co;2-g . DOI: 10.1002/(sici)1097-0142(19981015)83:8<1664::aid-cncr23>3.0.co;2-g. PMID: 9781962.

3. Yde SS, Sjoegren P, Heje M, Stolle LB. 2018; Mucosal melanoma: a literature review. Curr Oncol Rep. 20:28. https://doi.org/10.1007/s11912-018-0675-0 . DOI: 10.1007/s11912-018-0675-0. PMID: 29569184.

4. Lund VJ, Howard DJ, Harding L, Wei WI. 1999; Management options and survival in malignant melanoma of the sinonasal mucosa. Laryngoscope. 109(2 Pt 1):208–11. https://doi.org/10.1097/00005537-199902000-00007 . DOI: 10.1097/00005537-199902000-00007. PMID: 10890767.

5. Sapp JP, Eversole LR, Wysocki GP. 2004. Contemporary oral and maxillofacial pathology. Mosby;St. Louis:

6. Sun S, Huang X, Gao L, Zhang Y, Luo J, Zhang S, et al. 2017; Long-term treatment outcomes and prognosis of mucosal melanoma of the head and neck: 161 cases from a single institution. Oral Oncol. 74:115–22. https://doi.org/10.1016/j.oraloncology.2017.09.020 . DOI: 10.1016/j.oraloncology.2017.09.020. PMID: 29103739.

7. Napierała MJ, Czarnecka AM. 2019; Mucosal melanoma — clinical presentation and treatment based on a case series. Oncol Clin Pract. 15:223–30. https://doi.org/10.5603/OCP.2019.0001 . DOI: 10.5603/OCP.2019.0001.

8. Wu AJ, Gomez J, Zhung JE, Chan K, Gomez DR, Wolden SL, et al. 2010; Radiotherapy after surgical resection for head and neck mucosal melanoma. Am J Clin Oncol. 33:281–5. https://doi.org/10.1097/COC.0b013e3181a879f5 . DOI: 10.1097/COC.0b013e3181a879f5. PMID: 19823070.

9. National Comprehensive Cancer Network (NCCN). 2020. NCCN clinical practice guidelines in oncology: head and neck cancers. NCCN;Plymouth Meeting: p. 83–7.

10. Mendenhall WM, Amdur RJ, Hinerman RW, Werning JW, Villaret DB, Mendenhall NP. 2005; Head and neck mucosal melanoma. Am J Clin Oncol. 28:626–30. https://doi.org/10.1097/01.coc.0000170805.14058.d3 . DOI: 10.1097/01.coc.0000170805.14058.d3. PMID: 16317276.

11. López F, Rodrigo JP, Cardesa A, Triantafyllou A, Devaney KO, Mendenhall WM, et al. 2016; Update on primary head and neck mucosal melanoma. Head Neck. 38:147–55. https://doi.org/10.1002/hed.23872 . DOI: 10.1002/hed.23872. PMID: 25242350. PMCID: PMC4986507.

12. Gilligan D, Slevin NJ. 1991; Radical radiotherapy for 28 cases of mucosal melanoma in the nasal cavity and sinuses. Br J Radiol. 64:1147–50. https://doi.org/10.1259/0007-1285-64-768-1147 . DOI: 10.1259/0007-1285-64-768-1147. PMID: 1773274.

13. Bartell HL, Bedikian AY, Papadopoulos NE, Dett TK, Ballo MT, Myers JN, et al. 2008; Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck. 30:1592–8. https://doi.org/10.1002/hed.20910 . DOI: 10.1002/hed.20910. PMID: 18798304.

14. Manolidis S, Donald PJ. 1997; Malignant mucosal melanoma of the head and neck: review of the literature and report of 14 patients. Cancer. 80:1373–86. https://doi.org/10.1002/(sici)1097-0142(19971015)80:8<1373::aid-cncr3>3.0.co;2-g . DOI: 10.1002/(sici)1097-0142(19971015)80:8<1373::aid-cncr3>3.0.co;2-g. PMID: 9338460.

15. Lazarev S, Gupta V, Hu K, Harrison LB, Bakst R. 2014; Mucosal melanoma of the head and neck: a systematic review of the literature. Int J Radiat Oncol Biol Phys. 90:1108–18. https://doi.org/10.1016/j.ijrobp.2014.03.042 . DOI: 10.1016/j.ijrobp.2014.03.042. PMID: 25539369.

16. Bachar G, Loh KS, Goldstein D, Wood S, Brown D, et al. O’Sullivan B. 2008; Mucosal melanomas of the head and neck: experience of the Princess Margaret Hospital. Head Neck. 30:1325–31. https://doi.org/10.1002/hed.20878 . DOI: 10.1002/hed.20878. PMID: 18704964.

17. Martin JM, Porceddu S, Weih L, Corry J, Peters LJ. 2004; Outcomes in sinonasal mucosal melanoma. ANZ J Surg. 74:838–42. https://doi.org/10.1111/j.1445-1433.2004.03185.x . DOI: 10.1111/j.1445-1433.2004.03185.x. PMID: 15456427.

18. Jethanamest D, Vila PM, Sikora AG, Morris LG. 2011; Predictors of survival in mucosal melanoma of the head and neck. Ann Surg Oncol. 18:2748–56. https://doi.org/10.1245/s10434-011-1685-4 . DOI: 10.1245/s10434-011-1685-4. PMID: 21476106. PMCID: PMC3155852.

19. Moya-Plana A, Herrera Gómez RG, Rossoni C, Dercle L, Ammari S, Girault I, et al. 2019; Evaluation of the efficacy of immunotherapy for non-resectable mucosal melanoma. Cancer Immunol Immunother. 68:1171–8. https://doi.org/10.1007/s00262-019-02351-7 . DOI: 10.1007/s00262-019-02351-7. PMID: 31172258.

20. Hamid O, Robert C, Ribas A, Hodi FS, Walpole E, Daud A, et al. 2018; Antitumour activity of pembrolizumab in advanced mucosal melanoma: a post-hoc analysis of KEYNOTE-001, 002, 006. Br J Cancer. 119:670–4. https://doi.org/10.1038/s41416-018-0207-6 . DOI: 10.1038/s41416-018-0207-6. PMID: 30202085. PMCID: PMC6173747.

21. Weber J, Mandala M, Del Vecchio M, Gogas HJ, Arance AM, Cowey CL, et al. 2017; ; CheckMate 238 Collaborators. Adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. N Engl J Med. 377:1824–35. https://doi.org/10.1056/NEJMoa1709030 . DOI: 10.1056/NEJMoa1709030. PMID: 28891423.

22. Si L, Zhang X, Shu Y, Pan H, Wu D, Liu J, et al. 2019; A phase Ib study of pembrolizumab as second-line therapy for Chinese patients with advanced or metastatic melanoma (KEYNOTE-151). Transl Oncol. 12:828–35. https://doi.org/10.1016/j.tranon.2019.02.007 . DOI: 10.1016/j.tranon.2019.02.007. PMID: 30981094. PMCID: PMC6458446.

23. Manton T, Tillman B, McHugh J, Bellile E, McLean S, McKean E. 2019; Sinonasal melanoma: a single institutional analysis and future directions. J Neurol Surg B Skull Base. 80:484–92. https://doi.org/10.1055/s-0038-1676355 . DOI: 10.1055/s-0038-1676355. PMID: 31534890. PMCID: PMC6748852.