Current concepts in advanced sinonasal mucosal melanoma: a single institution experience.

Current concepts in advanced sinonasal mucosal melanoma: a single institution experience.

Publication date: May 16, 2019

To present outcome measures of sinonasal mucosal melanoma (SMM) patients with particular focus on current radiological and therapeutic options, especially in the non-curative setting (immunotherapy).

Retrospective study on SMM patients treated at our institution between January 1992 and December 2018.

FDG-PET/MRI has emerged as the new hybrid imaging modality, addressing the need for high local tissue contrast in the paranasal sinuses and the skull base, while allowing for whole-body staging in search for distant metastases, including the brain. Primary treatment protocols consisted of tumor resection in 30/34 patients (88%), palliative radiation therapy (RT) in 3/34 patients (9%) and best supportive care therapy in 1/34 patient (3%). Of all the initially operated patients, 25/30 patients (83%) received adjuvant RT. A total of 9/34 patients (26%) was treated with immunotherapy after the previous combined therapy. For patients treated in curative intention, we observed a 1-year overall survival (OS) of 60% (18/30 patients) and a 3-year OS of 40% (12/30 patients). For patients treated with immunotherapy, median progression-free survival (PFS) was 5 months (IQR 0-13.75), with a maximum PFS of 16 months (combination of nivolumab and ipilimumab). However, there was no difference in OS in patients treated with immunotherapy vs. no immunotherapy (log rank 0.99).

Sinonasal mucosal melanoma is a highly aggressive tumor, requiring multimodal therapy and developing a substantial incidence of distant metastases. The introduction of FDG-PET/MRI offers new possibilities in the radiological assessment of the tumor and immunotherapy has altered the management in the non-curative setting, resulting in a substantial progression-free survival in selected cases.

Meerwein, C.M., H”ullner, M., Braun, R., Soyka, M.B., Morand, G.B., and Holzmann, D. Current concepts in advanced sinonasal mucosal melanoma: a single institution experience. 22667. 2019 Eur Arch Otorhinolaryngol.

Concepts Keywords
Adjuvant Radiation
Brain MRI
FDG Radiation therapy
Hybrid Treatment protocols
Immunotherapy Cancer
Incidence Melanoma
Ipilimumab Medicine
IQR Health
Metastases RTT
Modality Branches of biology
MRI Ipilimumab
Palliative Progression-free survival
Paranasal Sinuses Immunotherapy
PET Radiation therapy
Radiation Therapy Treatment protocols
Resection Sinonasal mucosal melanoma
RT Melanoma
Skull Base Highly aggressive tumor
Supportive Care Tumor
Tumor Treatment protocols
Hybrid imaging modality

Semantics

Type Source Name
pathway BSID Melanoma
disease DOID Melanoma
disease MESH Melanoma
gene UNIPROT TNFRSF11A
drug DRUGBANK Ipilimumab
drug DRUGBANK Nivolumab
gene UNIPROT BEST1
disease MESH tumor
disease MESH metastases
gene UNIPROT CYREN
gene UNIPROT SMUG1
disease DOID mucosal melanoma

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