Table of Contents
ISRN Oncology
Volume 2012, Article ID 785131, 7 pages
http://dx.doi.org/10.5402/2012/785131
Research Article

Mucosal Melanomas of the Head and Neck: The Role of Postoperative Radiation Therapy

1Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, University of Miami, 1475 NW 12th Ave, Suite 1500, Miami, FL 33136, USA
2Department of Radiation Oncology, Jackson Memorial Hospital, Miami, FL 33136, USA
3Department of Otolaryngology—Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, University of Miami, Miami, FL 33136, USA
4Division of Biostatistics, Department of Epidemiology and Public Health and Biostatistics and Bioinformatics Core, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, University of Miami, Miami, FL 33136, USA

Received 12 December 2011; Accepted 18 January 2012

Academic Editors: C. Perez and J. Tovari

Copyright © 2012 Kunal Saigal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. Mucosal melanomas are rarer than their cutaneous counterparts and are associated with a poorer prognosis. We report the clinical outcomes of patients with mucosal melanomas of the head and neck region generally treated with definitive surgery followed by postoperative radiation therapy (RT). Methods. We reviewed the records of 17 patients treated at the University of Miami in 1990–2007. Patients generally received conventionally fractionated RT regimens to the postoperative bed. Elective nodal RT was not routinely delivered. Eight patients received adjuvant chemotherapy or immunotherapy. Results. Median followup was 35.2 months (range 5–225). As the first site of failure: 3 patients recurred locally, 2 regionally and 2 distantly. All 3 patients who recurred locally had not received RT. Of the 5 locoregional recurrences, 4 were salvaged successfully with multimodality therapy with no evidence of disease at last followup. Overall survival was 64.7% at 2 years and 51.5% at 5 years. Conclusions. Patients with mucosal melanoma of the head and neck are best treated with surgery to achieve negative margins, followed by postoperative RT to optimize local control. Elective nodal irradiation may not be indicated in all cases, as regional failures were not predominant. Distant metastases were fewer when compared to historical data, potentially due to advancements in adjuvant therapies as well as aggressive multi-modality salvage at time of failure.