MUCOSAL MELANOMA OF THE UPPER AERODIGESTI VE TRACT

Background: Malignant mucosal melanoma of the upper aerodigestive trac t is a rare disease. The prognosis is expected to be significantly wor se than the prognosis of cutaneous melanoma and so far no uniform ther apeutic concept exists. Publications about mucosal melanoma are scarce and reported patient groups are usually small. Patients: Thirty-four patients have been registered at the ENT Department of the University of Kiel Medical Center with the diagnosis mentioned above. Clinical da ta were obtained from the patient's charts, the minimum follow-up was three years. Results: Most common site of the tumor was the nasal cavi ty and paranasal sinuses with 28 of 34 patients. Less frequently affec ted was the nasopharynx (three cases), oropharynx, larynx, and middle ear (one case each). All patients were caucasians and most of them wer e of an advanced age (66.9 years +/- 12.3). Treatment of choice was su rgical resection in 27 cases, in four cases it was combined with radia tion therapy, in one case with radiation therapy and chemotherapy, and in three cases with chemotherapy. Six patients received solely radiat ion therapy, one patient was only treated by chemotherapy. Patients wh o were treated by a combined approach had a more favourable outcome th an patients who were treated by a monotherapy of surgery, radiation th erapy, or chemotherapy. A high number of recurrences were observed, wh ich occurred on an average of 16.6 months after the diagnosis of the p rimary tumor. Overall 5-year survival was 45.8%, the 10-year survival rate was 22.3%. Conclusions: Optimized combined therapeutical approach es might possibly improve the prognosis of mucosal melanoma of the upp er aerodigestive tract. Intervals between follow-ups should be short t o render detection of relapses at an early stage. Repeated therapy of recurrent disease might lengthen survival.