P. F. Nocini
Section of Oral and Maxillofacial Surgery, Department of Surgery,
University of Verona, Verona, Italy
Department of Diagnostics and Public Health, Section of Pathology,
University of Verona, Verona, Italy
P. Procacci, Department of Surgery, Section of Oral and Maxillofacial
Surgery, University of Verona, Verona, Italy.
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Accepted: 29 September 2017
Comparative study of head and neck mucosal melanoma in 66
patients vs 226 patients with cutaneous melanoma: A survival
Melanoma is a neoplasm that results from the malignant transforma-
tion of melanocytes. Despite being one of the less frequent malignant
neoplasms of the skin, it has shown an increased incidence in the last
years. According to the Surveillance, Epidemiology and End Results
(SEER) program of the National Cancer Institute (NCI), the annual per-
centage of new cases is 4.5%, with a mortality rate of 1.7%. Cutaneous
melanomas (CM) account for 91.2% of cases, while 5.3% are ocular
melanomas, 1.3% mucosal melanomas (MM), and 2.2% are of
unknown primary origin.
Cutaneous melanoma, in contrast to MM,
has a clear relationship with exposure to UV rays. In the head and neck
region, MM represents up to 10% of the melanomas. Age at presenta-
tion for MM is higher than CM and is generally related with a worse
prognosis because of the high frequency of distant metastases.
tish study compared cutaneous melanoma of the head and neck
(HNCM) with the rest of the locations and reported an older age at
diagnosis and delayed diagnosis without finding significant differences
in survival between the different locations.
The most common loca-
tions for mucosal melanoma in the head and neck (HNMM) are the
nasal cavity, paranasal sinuses and oral cavity (mainly hard palate and
Due to the lack of dermis in MM, the classification used for
CM is not applicable. Furthermore, in an exhaustive review of the liter-
ature, we did not find any study that compares HNMM vs HNCM
and this makes necessary to study if melanomas located in this
anatomical region do behave differently according to site of origin. It is
noteworthy that the American Joint Committee on Cancer (AJCC) ini-
tiates classification of MM as T3, without an existing stage I or II. In
the literature review, reports showed that the 5-year overall survival
(OS) of CM varies between 79% and 95%, whereas OS of MM varies
between 20% and 30% with recurrences during the first year in up to
20% of cases and local failure in 54%.
The objectives of this study
were to compare the disease-free survival (DFS) and OS for HNMM vs
HNCM as well as according to the clinical stage between groups.
CORRESPONDENCE: OUR EXPERIENCE