Clinical Review of Mucosal Melanoma: The 11-Year Experience of a Referral Center
Introduction: Mucosal melanoma is a rare neoplasm. Late diagnosis is caused by occult anatomic sites and scarcity of symptoms. Novel biological therapies have now become available. Demographic, therapeutical and survival records on mucosal melanoma are scarce. Objectives: To provide an 11-year r...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Mattioli1885
2023-01-01
|
| Series: | Dermatology Practical & Conceptual |
| Subjects: | |
| Online Access: | https://dpcj.org/index.php/dpc/article/view/2582 |
| _version_ | 1797935130736590848 |
|---|---|
| author | Marco Spadafora Giacomo Santandrea Michela Lai Stefania Borsari Shaniko Kaleci Maria Banzi Vincenzo Dario Mandato Giovanni Pellacani Simonetta Piana Caterina Longo |
| author_facet | Marco Spadafora Giacomo Santandrea Michela Lai Stefania Borsari Shaniko Kaleci Maria Banzi Vincenzo Dario Mandato Giovanni Pellacani Simonetta Piana Caterina Longo |
| author_sort | Marco Spadafora |
| collection | DOAJ |
| description |
Introduction: Mucosal melanoma is a rare neoplasm. Late diagnosis is caused by occult anatomic sites and scarcity of symptoms. Novel biological therapies have now become available. Demographic, therapeutical and survival records on mucosal melanoma are scarce.
Objectives: To provide an 11-year retrospective clinical review of real-world data on mucosal melanomas managed in a tertiary referral center in Italy.
Methods: We included patients with histopathological mucosal melanoma diagnosis from January 2011 to December 2021. Data were collected until last known follow up or death. Survival analysis was performed.
Results: Among 33 patients, we found 9 sinonasal, 13 anorectal and 11 urogenital mucosal melanomass (median age 82, females 66.7%). Eighteen cases (54.5%) presented with metastasis (p<0.05). In the urogenital subgroup, only 4 patients (36.4%) had metastasis at diagnosis, all in regional lymph nodes. Sinonasal melanomas were surgically managed with a debulking procedure (44.4%); every case of anorectal and urogenital melanomas underwent radical surgery (30.8% and 45.5%). Fifteen patients were treated with biological therapy (p<0.05). Radiation therapy was used in all melanomas of the sinonasal region (p<0.05). Overall survival was longer for urogenital melanomas (26 months). Univariate analysis showed an increased hazard ratio for death in patients with metastasis. A negative prognostic value of metastatic status was reported by the multivariate model, while administration of first-line immunotherapy demonstrated a protective role.
Conclusions: At diagnosis, the absence of metastatic disease is the most relevant factor that influences the survival of mucosal melanomas. Moreover, the use of immunotherapy might prolong the survival of metastatic mucosal melanoma patients.
|
| first_indexed | 2024-04-10T18:10:39Z |
| format | Article |
| id | doaj.art-a0c3fa2cf30c4e0fa87d33c8ea9cc5a5 |
| institution | Directory Open Access Journal |
| issn | 2160-9381 |
| language | English |
| last_indexed | 2024-04-10T18:10:39Z |
| publishDate | 2023-01-01 |
| publisher | Mattioli1885 |
| record_format | Article |
| series | Dermatology Practical & Conceptual |
| spelling | doaj.art-a0c3fa2cf30c4e0fa87d33c8ea9cc5a52023-02-02T11:15:52ZengMattioli1885Dermatology Practical & Conceptual2160-93812023-01-0113110.5826/dpc.1301a57Clinical Review of Mucosal Melanoma: The 11-Year Experience of a Referral CenterMarco Spadafora0Giacomo Santandrea1Michela Lai2Stefania Borsari3Shaniko Kaleci4Maria Banzi5Vincenzo Dario Mandato6Giovanni Pellacani7Simonetta Piana8Caterina Longo9Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, ItalyClinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, ItalyClinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, ItalyCentro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, ItalyMedical Oncology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, ItalyUnit of Obstetrics and Gynecology, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy.Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.Pathology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, ItalyDepartment of Dermatology, University of Modena and Reggio Emilia, Modena, Italy Introduction: Mucosal melanoma is a rare neoplasm. Late diagnosis is caused by occult anatomic sites and scarcity of symptoms. Novel biological therapies have now become available. Demographic, therapeutical and survival records on mucosal melanoma are scarce. Objectives: To provide an 11-year retrospective clinical review of real-world data on mucosal melanomas managed in a tertiary referral center in Italy. Methods: We included patients with histopathological mucosal melanoma diagnosis from January 2011 to December 2021. Data were collected until last known follow up or death. Survival analysis was performed. Results: Among 33 patients, we found 9 sinonasal, 13 anorectal and 11 urogenital mucosal melanomass (median age 82, females 66.7%). Eighteen cases (54.5%) presented with metastasis (p<0.05). In the urogenital subgroup, only 4 patients (36.4%) had metastasis at diagnosis, all in regional lymph nodes. Sinonasal melanomas were surgically managed with a debulking procedure (44.4%); every case of anorectal and urogenital melanomas underwent radical surgery (30.8% and 45.5%). Fifteen patients were treated with biological therapy (p<0.05). Radiation therapy was used in all melanomas of the sinonasal region (p<0.05). Overall survival was longer for urogenital melanomas (26 months). Univariate analysis showed an increased hazard ratio for death in patients with metastasis. A negative prognostic value of metastatic status was reported by the multivariate model, while administration of first-line immunotherapy demonstrated a protective role. Conclusions: At diagnosis, the absence of metastatic disease is the most relevant factor that influences the survival of mucosal melanomas. Moreover, the use of immunotherapy might prolong the survival of metastatic mucosal melanoma patients. https://dpcj.org/index.php/dpc/article/view/2582Mucosal melanomadiagnosistreatmentsrare disease |
| spellingShingle | Marco Spadafora Giacomo Santandrea Michela Lai Stefania Borsari Shaniko Kaleci Maria Banzi Vincenzo Dario Mandato Giovanni Pellacani Simonetta Piana Caterina Longo Clinical Review of Mucosal Melanoma: The 11-Year Experience of a Referral Center Dermatology Practical & Conceptual Mucosal melanoma diagnosis treatments rare disease |
| title | Clinical Review of Mucosal Melanoma: The 11-Year Experience of a Referral Center |
| title_full | Clinical Review of Mucosal Melanoma: The 11-Year Experience of a Referral Center |
| title_fullStr | Clinical Review of Mucosal Melanoma: The 11-Year Experience of a Referral Center |
| title_full_unstemmed | Clinical Review of Mucosal Melanoma: The 11-Year Experience of a Referral Center |
| title_short | Clinical Review of Mucosal Melanoma: The 11-Year Experience of a Referral Center |
| title_sort | clinical review of mucosal melanoma the 11 year experience of a referral center |
| topic | Mucosal melanoma diagnosis treatments rare disease |
| url | https://dpcj.org/index.php/dpc/article/view/2582 |
| work_keys_str_mv | AT marcospadafora clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT giacomosantandrea clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT michelalai clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT stefaniaborsari clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT shanikokaleci clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT mariabanzi clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT vincenzodariomandato clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT giovannipellacani clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT simonettapiana clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter AT caterinalongo clinicalreviewofmucosalmelanomathe11yearexperienceofareferralcenter |