%0 Multicenter Study
%T Recurrence patterns among patients with sinonasal mucosal melanoma: A multi-institutional study.
%A Pandrangi VC
%A Mace JC
%A Abiri A
%A Adappa ND
%A Beswick DM
%A Chang EH
%A Eide JG
%A Fung N
%A Hong M
%A Johnson BJ
%A Kohanski MA
%A Kshirsagar RS
%A Kuan EC
%A Le CH
%A Lee JT
%A Nabavizadeh SA
%A Obermeyer IP
%A Palmer JN
%A Pinheiro-Neto CD
%A Smith TL
%A Snyderman CH
%A Suh JD
%A Wang EW
%A Wang MB
%A Choby G
%A Geltzeiler M
%J Int Forum Allergy Rhinol
%V 13
%N 12
%D 2023 Dec 2
%M 37265013
%F 5.426
%R 10.1002/alr.23204
%X <B>OBJECTIVE: </B>To evaluate recurrence patterns and survival after recurrence among patients with sinonasal mucosal melanoma (SNMM).<BR><B>METHODS: </B>This was a multi-institutional retrospective review from seven U.S. institutions of patients with SNMM from 1991 to 2022. Recurrence was categorized as local, regional, distant, or multifocal. Kaplan-Meier tests were used to evaluate disease-free survival (DFS), overall survival (OS), and post-recurrence survival (PRS) reported with standard errors (SE) and log-rank testing used for comparison. Cox-regression was further used, with hazard ratios (HR) and 95% confidence intervals (CI) reported.<BR><B>RESULTS: </B>Among 196 patients with SNMM, there were 146 patients with recurrence (74.5%). Among all patients, 60-month DFS (SE) was 15.5% (2.9%), 60-month OS (SE) was 44.7% (3.7%), mean age ± standard deviation at diagnosis was 69.7 ± 12.5 years, and 54.6% were female. In 26 patients who underwent primary treatment of the neck, 60-month DFS did not differ from no treatment (p > 0.05). Isolated distant recurrence was most common (42.8%), followed by local (28.3%), multifocal (20.7%), and regional recurrence (8.3%). Among patients with regional recurrence in the neck, there was no 60-month PRS benefit for patients undergoing salvage neck dissection or radiation (p > 0.05). Among patients with distant recurrence, only immunotherapy was associated with improved 12-month PRS (HR = 0.32, 95% CI = 0.11-0.92, p = 0.034), and no treatment group was associated with improved 24- or 60-month PRS (p > 0.05).<BR><B>CONCLUSIONS: </B>SNMM is associated with a high recurrence rate and poor survival. Primary treatment of the neck was not associated with reduced recurrence, and immunotherapy for treatment of distant recurrence was associated with increased 12-month PRS.