Malignant mucosal melanoma of the head and neck: Results of surgical treatment of 40 cases

Abstract

A total of 40 patients with previously untreated mucosal malignant melanoma of the head and neck underwent resection at our hospital between 1980 and 2010. We reviewed the clinical data of these 40 patients. There were 20 men and 20 women, aged 24-79 years (median: 62 years). The site of the primary lesion was the nasal/paranasal cavity in 28 patients, oral cavity in 9 patients, and pharynx in 3 patients. The clinical TNM classification according to the 7th AJCC/UICC was as follows: Stage III, 6 cases; Stage IVA, 23 cases; Stage IVB, 9 cases; T3, 8 cases; T4a, 23 cases; and T4b, 9 cases. The 5-year overall survival rate according to the TNM Stage was 100% for Stage III, 46% for Stage IVA, and 11% for Stage IVB. The 5-year overall survival rate (Kaplan-Meier method) was 43%, the 5-year local control rate was 70%, and the disease-free survival rate was 29%. In this study, the TNM classification was well correlated with the clinical outcome; especially, the prognosis of patients with T4b and N1 was poor. A local recurrence was a therapeutic challenge for the maxillary tuberosity and the pterygoid direction. The subsequent cervical lymph node metastasis rate was high, but neck dissection was considered to have a definitive beneficial effect on survival.