Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Pomberger, M.
Sinonasal Mucosal Melanoma: Therapeutic Strategies and Survival for a rare Disease Entity
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2019. pp. 50
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Thurnher Dietmar
- Tomazic Peter Valentin
- Altmetrics:
- Abstract:
- Introduction: Sinonasal mucosal melanoma (SNMM) is a rare disease entity comprising 0.4% to 1.3% of all melanomas. Surgery with free margins has been the primary treatment over decades. Neither the addition of radiotherapy nor chemotherapy could significantly improve outcome rates of this devastating malignancy. This study presents all cases with Sinonasal Mucosal Melanoma treated at the Medical University of Graz and shows treatment and outcome of these patients and summarizes current literature for treatment options and outcomes. Methods: A retrospective patient chart review of all patients diagnosed with SNMM and treated at the Department of Otorhinolaryngology at the Medical University of Graz from 2001 to 2017 were included. Twelve patients were identified, and patient charts were searched for treatment and outcome data. For the literature review, PubMed was systematically searched for articles meeting the following criteria: English or German language and full text articles available, patient data not dating back 1990, patient number over 10, treatment data including surgery and radiotherapy and overall survival outcome data. Results: Six patients were female, and 6 patients were over 65 years old. Out of 12 patients, 9 received endoscopic surgery. Main symptoms were Epistaxis and nasal obstruction. Six patients received adjuvant radiotherapy, and 3 patients received additional chemotherapy. One patient received adjuvant immunotherapy. Three patients, who did not undergo surgery, received chemoradiotherapy, radiotherapy alone, and chemotherapy alone, respectively. At the time of diagnosis 2 patients had distant metastases, 4 patients developed distant metastases during the course of the disease. Mean overall survival (OS) was 30,6 months, 3- and 5-year-OS was 25%, and 18.2%, respectively. Conclusions: Unspecific symptoms and hidden anatomic locations lead to delayed diagnosis and increased rates of metastatic spread. Distant metastasis is the main treatment failure in SNMM. Surgery with free margins remains the primary treatment for SNMM. The oncological efficacy of endoscopic resection seems to be similar to external approaches. Adjuvant radiotherapy might improve local control in individual cases, yet efficient systemic therapy is needed to improve outcome rates. To evaluate and define more effective targeted treatment options and improve outcome rates, homogenous data and prospective multicentric analysis is needed.