MUCOSAL MELANOMA OF THE HEAD AND NECK - THE IMPACT OF LOCAL-CONTROL ON SURVIVAL

The management for mucosal melanoma of the head and neck is controvers ial in view of the poor prognosis. Thirty-five patients seen from 1955 to 1991 were analyzed retrospectively. Almost all (34/35) presented w ith localized disease. Primary treatments included radical surgery (15 ), local resection (11), radiation therapy (6), or systemic treatment (2). While the rate of local recurrence was high (27/34), only 5 patie nts developed distant disease before local relapse. Furthermore, only 5/21 achieved successful local salvage. Patients with their disease co ntrolled locally had significantly longer survival than those with per sistent local disease (P = .0001). The 5-year disease-specific surviva l was 45%. The authors conclude that mucosal melanoma of the head and neck is not necessarily incurable. When local control is achieved, sur vival rate is significantly improved. Aggressive local treatments shou ld be initiated at presentation of this disease.