Adjuvant radiotherapy in sinonasal mucosal melanoma: A retrospective analysis

Abstract

Objectives

Evaluation of outcome after curative treatment for sinonasal mucosal melanoma, focused on the effect of adjuvant radiotherapy on recurrence and survival. Design. Retrospective chart analysis. Setting. Tertiary referral hospital. Participants. 51 patients with primary sinonasal mucosal melanoma who underwent surgical resection with curative intention between 1980 and 2016 at Erasmus Medical Center Rotterdam. Main outcome measures. Patients were categorised into two groups: surgery alone and surgery with adjuvant radiotherapy. Log-rank test was used to compare rates of recurrence and survival between treatment groups. Predictors for treatment modality, recurrence and survival were assessed with multivariate statistical analysis.

Results

Of all patients, 23.5% developed local recurrence and 47.1% developed distant metastasis. Estimated 5-year disease free survival was 25.2% and 5-year overall survival was 38.1%. 43 patients (84.3%) were treated with postoperative radiotherapy. Patients who underwent surgery with adjuvant radiotherapy presented more often with high tumour stage, tumour involving multiple sites and positive margins. Postoperative radiotherapy seemed to be associated with better local control (p=0.549). No effect was found on occurrence of distant metastasis and overall survival. Positive margin status was an independent negative predictor for distant metastasis-free survival and overall survival

Conclusions

Our treatment outcomes are consistent with literature. Postoperative radiotherapy seems to be associated with improved local control despite advanced disease and positive margin status in this treatment group.

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