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Oncologic outcomes, prognostic factor analysis and therapeutic algorithm evaluation of head and neck mucosal melanomas in France

A. Auperin 1 R. Obongo 1 F.R. Ferrand 2 N. Saroul 3 F. Janot 4 S. Albert 5 G. Andry 6 E. Babin 7 C. Bach 8 J.-M. Badet C. Badoual A.C. Baglin 9 A. Banal B. Barry 10 E. Baudin 11 B. Baujat 12 R.J. Bensadoun C. Bertolus J.-P. Bessède D. Blanchard C. Borel 13 A. Bozorg-Grayeli R. Breheret P. Breton L. Brugel G. Calais 14 O. Casiraghi 1 E. Cassagnau L. Castillo P. Ceruse 15 F. Chabolle D. Chevalier 16 J.C. Chobaut O. Choussy 17 A. Cosmidis 18 A. Coste V. Costes 19 L. Crampette 20 V. Darrouzet 21 P. Demez P. Dessi 22 B. Devauchelle 23 L. Digue G. Dolivet 24 F. Dubrulle 25 S. Duflo X. Dufour C. Even S. Faivre N. Fakhry 22 C. Ferron 26 F. Floret 27 L. de Gabory 28 R. Garrel 29 L. Geoffrois 24 L. Gilain A. Giovanni 30 A. Girod B. Guerrier 31 S. Hans 32 P. Herman 33, 34 P. Hofman 35 M. Housset R. Jankowski 36 F. Jegoux 37 M. Juliéron M.-C. Kaminsky F. Kolb J. Lacau St Guily 38 L. Laccoureye B. Lallemant 39 P. Lang 40 E. Lartigau 41 J.-P. Lavieille M. Lefevre X. Leroy O. Malard 42 F. Massip 43 O. Mauvais J.-C. Merol 44 J. Michel 45 T. Mom S. Morinière 46 E. de Mones 21 G. Moulin A. Moya-Plana 1 G. Noël 47 G. Poissonnet 48 J.-M. Prades D. de Raucourt 7 E. Reyt 49 C. Righini 50 Y. Marie Robin F. Rolland 51 B. Ruhin N. Sarroul 3 P. Schultz 52 E. Serrano O. Sterkers 53 V. Strunski A. Sudaka M. Tassart 54 S. Testelin 23 J. Thariat 55 A. Timochenko B. Toussaint E. Uro Coste G. Valette T. van den Abbeele A. Varoquaux 56 F. Veillon 57 S. Vergez 58 B. Vérillaud 59 M. Wassef 60
11 Médecine nucléaire
Département d'imagerie médicale [Gustave Roussy]
43 Statistique en grande dimension pour la génomique
PEGASE - Département PEGASE [LBBE]
Abstract : BACKGROUND: Head and neck mucosal melanoma (HNMM) is aggressive and rare, with a poor prognosis because of its high metastatic potential. The two main subtypes are sinonasal (sinonasal mucosal melanoma [SNMM]) and oral cavity (oral cavity mucosal melanoma [OCMM]). Consensual therapeutic guidelines considering the primary tumour site and tumour-node-metastasis (TNM) stage are not well established. MATERIAL & METHODS: Patients with HNMM from the prospective national French Rare Head and Neck Cancer Expert Network database between 2000 and 2017 were included. Clinical characteristics, treatment modalities, outcomes and prognostic factors were analysed. RESULTS: In total, 314 patients were included. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 49.4% and 24.7%, respectively, in the surgery group; no long-term survivors were observed when surgery was not feasible. Moreover, even after surgery, a high recurrence rate was reported with a median PFS of 22 months. In multivariate analysis, Union for International Cancer Control (UICC) stage and tumour site correlated with PFS and OS. Postoperative radiotherapy (PORT) improved the PFS but not OS in patients with small (T3) SNMM and OCMM tumours. Nodal involvement was more frequent in patients with OCMM (p < 10-4), although, as in SNMM, it was not a significant prognostic predictor. CONCLUSION: Even early HNMM was associated with poor oncologic outcomes due to distant metastases despite surgical resection with clear margins. Lymph node metastases had no impact on the prognosis, suggesting treatment de-escalation in cervical node management. PORT might be useful for local control.
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https://hal.umontpellier.fr/hal-02548630
Contributeur : Nathalie Salvy-Cordoba <>
Soumis le : lundi 20 avril 2020 - 18:11:12
Dernière modification le : mardi 26 mai 2020 - 18:50:32

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A. Auperin, R. Obongo, F.R. Ferrand, N. Saroul, F. Janot, et al.. Oncologic outcomes, prognostic factor analysis and therapeutic algorithm evaluation of head and neck mucosal melanomas in France. European Journal of Cancer, Elsevier, 2019, 123, pp.1-10. ⟨10.1016/j.ejca.2019.09.007⟩. ⟨hal-02548630⟩

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