MUCOSAL MELANOMA OF THE HEAD AND NECK

Two hundred and fifty-nine patients with mucosal melanoma of the head and neck were reviewed. The data of these patients were obtained from the records of the Department of Head and Neck Oncology at the Univers ity of Liverpool and from the Merseyside and Cheshire Cancer Registry. Survival curves were constructed using the life table method and diff erences were investigated by the Log Rank Test. Prognostic factors wer e further analysed by Cox's proportional hazards model. Melanomas of t he nasal cavities and sinuses accounted for 69%; 22% occurred in the o ral cavity and 9% in the pharynx, larynx and upper oesophagus. In 49% treatment was by wide local resection and in 8% by irradiation. Thirty -six per cent had combined modalities of treatment. Primary site recur rence occurred in 52% and 36% developed nodal recurrence. The tumour s pecific survival at 5 years was 45% at 10 years 28%, at 20 years 17% a nd closely resembled the observed survival. Young male patients tended to have a favourable prognosis as did those treated surgically. Radio therapy on its own was ineffective. Amelanotic melanoma had a particul arly poor survival. Whereas site had no effect on survival. The study confirms the poor prognosis of mucosal melanoma of the head and neck. Young patients should be offered radical surgical treatment combined w ith radical radiotherapy if feasible as this offers the best chance of cure.