Surgical Margin Status and Survival Following Resection of Sinonasal Mucosal Melanoma

Samer T. Elsamna, Salma Ahsanuddin, Ghayoour S. Mir, Donata Sukyte-Raube, Christina H. Fang, Soly Baredes, Jean Anderson Eloy

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: Sinonasal mucosal melanoma (SNMM) is an aggressive cancer usually managed with surgical resection. This study evaluates the impact of treatment modality and positive surgical margin (PSM) on survival following resection of SNMM. Study Design: Retrospective study of a national cancer registry. Methods: The National Cancer Database was queried for cases of SNMM from 2010 to 2015. Data regarding patient demographics, tumor staging, and treatment modality were obtained. Survival rates were compared by margin status: PSM, negative (NSM), and no operation (0SM) using Kaplan–Meier analysis and log rank test. Results: A total of 446 patients met inclusion criteria. Most cases were elderly (>66 years-old) (67.3%), female (54.3%), and white (89.5%). Cases of SNMM most commonly involved the nasal cavity (81.6%), were Stage 3 (60.0%), and underwent surgical resection at an academic center (65.0%). NSM and PSM were present in 59.0% and 26.9% of cases, respectively, while 14.1% of cases did not undergo surgical resection (0SM). Factors predictive of PSM included resection at a community hospital (OR 2.47) and Stage 4 disease (OR 2.07). The 2-year survival rates were 72.1% (95% CI 69.4–75.4%), 36.3% (95% CI 22.0–48.9), and 16.0% (95% CI 8.2–25.4%) for NSM, PSM and 0SM, respectively. Survival was statistically significant between NSM and PSM (Log rank <0.001) but not between 0SM and PSM (Log rank = 0.062). Conclusion: Our study emphasizes the need for NSM for SNMM as PSM did not demonstrate any significant improvement in survival when compared to 0SM. Our findings suggest that cases of SNMM are best managed at academic centers. Level of Evidence: 4 Laryngoscope, 131:2429–2435, 2021.

Original languageEnglish (US)
Pages (from-to)2429-2435
Number of pages7
JournalLaryngoscope
Volume131
Issue number11
DOIs
StatePublished - Nov 2021
Externally publishedYes

Keywords

  • margin status
  • sinonasal cancer
  • Sinonasal mucosal melanoma
  • survival

ASJC Scopus subject areas

  • Otorhinolaryngology

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