Open Access Highly Accessed Research article

Impact of different surgical and postoperative adjuvant treatment modalities on survival of sinonasal malignant melanoma

Xin-Jun Meng15, Hua-Fei Ao2, Wei-Ting Huang1, Fu Chen3, Xi-Cai Sun1, Jing-Jing Wang1, Zhuo-Fu Liu1, Wade W Han4, Allison N Fry4 and De-Hui Wang1*

Author Affiliations

1 Department of Otolaryngology-Head and Neck Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China

2 Department of Otolaryngology, Shanghai 3rd People’s Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai 201900, China

3 Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai 200031, China

4 Florida Ear Nose Throat and Facial Plastic Surgery, Orlando, Florida 32819, USA

5 Department of Otolaryngology, Ruijin Hospital, School of medicine, Shanghai Jiao Tong University, Shanghai 200025, China

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BMC Cancer 2014, 14:608  doi:10.1186/1471-2407-14-608

Published: 23 August 2014

Abstract

Background

The role of postoperative adjuvant treatment for sinonasal malignant melanoma remains unclear. This study evaluates the impact of three different surgical and postoperative adjuvant treatment modalities: surgery alone(open and endoscopic approaches), surgery plus radiotherapy and surgery, radiotherapy plus chemotherapy on survival of patients with primary sinonasal malignant melanoma (SMM).

Methods

The data of 69 patients who underwent primary surgical treatments at Eye & ENT hospital of Fudan University between January 1st, 2000 and December 31st, 2010 were retrospectively reviewed. Survival comparison of different surgical and postoperative adjuvant treatment modalities (surgery alone, surgery plus radiotherapy and surgery, radiotherapy plus chemotherapy), as well as survival comparison between open and endoscopic surgical approaches were performed. Curves depicting survival were performed using Kaplan-Meier method. Statistical analysis was performed using log-rank test software SPSS19 and p < .05 is considered as statistically significant.

Results

The median overall survival time was found to be 18 months for surgery alone (27 cases), 32 months for surgery plus radiotherapy (24 cases), 42 months for surgery, radiotherapy plus chemotherapy (18 cases). The 3 and 5 year survival rates for groups mentioned above were 14.8% and 5.6%, 45.1% and 31.6%, 55% and 32.1%, respectively. Statistical significances were found not only between surgery alone and surgery plus radiotherapy treatment group (P = 0.012), but also surgery alone and surgery, radiotherapy plus chemotherapy group (P = 0.002). There was no statistically significant survival difference found between the two different surgical approaches (41 cases for open approach and 28 cases for endoscopic approach).

Conclusions

Sinonasal malignant melanoma is a disease with a poor prognosis. Patients who underwent surgery plus radiotherapy or surgery, radiotherapy plus chemotherapy had better survival outcomes than those underwent surgery alone. Endoscopic approach provided similar survival outcome as an open approach.

Keywords:
Sinonasal; Melanoma; Prognosis; Endoscopic sinonasal surgery; Radiotherapy; Chemotherapy