International Multicenter Study of Clinical Outcomes of Sinonasal Melanoma Shows Survival Benefit for Patients Treated with Immune Checkpoint Inhibitors and Potential Improvements to the Current TNM Staging System

被引：20

作者：

Lechner, Matt ^{[1
,2
,3
]}

Takahashi, Yoko ^{[4
]}

Turri-Zanoni, Mario ^{[5
]}

Ferrari, Marco ^{[6
]}

Liu, Jacklyn ^{[1
]}

Counsell, Nicholas ^{[7
,8
]}

Mattavelli, Davide ^{[9
]}

Rampinelli, Vittorio ^{[9
]}

Vermi, William ^{[9
]}

Lombardi, Davide ^{[9
]}

Saade, Rami ^{[4
,10
]}

Park, Ki Wan ^{[11
]}

Schartinger, Volker H. ^{[12
]}

Franchi, Alessandro ^{[13
]}

Facco, Carla ^{[14
]}

Sessa, Fausto ^{[14
]}

Battocchio, Simonetta ^{[15
]}

Fenton, Tim R. ^{[16
]}

Vaz, Francis M. ^{[17
,18
]}

O'Flynn, Paul ^{[17
,18
]}

Howard, David ^{[17
,18
]}

Stimpson, Paul ^{[17
,18
]}

Wang, Simon ^{[19
]}

Hannan, S. Alam ^{[17
,18
]}

Unadkat, Samit ^{[17
,18
]}

Hughes, Jonathan ^{[20
]}

Dwivedi, Raghav ^{[20
]}

Forde, Cillian T. ^{[17
,18
]}

Randhawa, Premjit ^{[17
,18
]}

Gane, Simon ^{[17
,18
]}

Joseph, Jonathan ^{[17
,18
]}

Andrews, Peter J. ^{[17
,18
]}

Dave, Manas ^{[21
]}

Fleming, Jason C. ^{[23
]}

Thomson, David ^{[22
,23
]}

Zhu, Tianyu ^{[24
]}

Teschendorff, Andrew ^{[24
]}

Royle, Gary ^{[1
]}

Steele, Christopher ^{[1
]}

Jimenez, Joaquin E. ^{[25
]}

Laco, Jan ^{[26
,27
]}

Wang, Eric W. ^{[25
,28
]}

Snyderman, Carl ^{[25
,28
]}

Lacy, Peter D. ^{[29
]}

Woods, Robbie ^{[29
]}

O'Neill, James P. ^{[29
,30
]}

Saraswathula, Anirudh ^{[31
]}

Kaur, Raman Preet ^{[31
]}

Zhao, Tianna ^{[32
]}

Ramanathan, Murugappan, Jr. ^{[31
,32
]}

机构：

[1] UCL, UCL Canc Inst, London WC1E 6DD, England

[2] UCL, UCL Div Surg & Intervent Sci, London, England

[3] Barts Hlth NHS Trust, Dept ENT, London, England

[4] Univ Texas MD Anderson Canc Ctr, Dept Head & Neck Surg, Houston, TX 77030 USA

[5] Univ Insubria, Dept Biotechnol & Life Sci, Unit Otorhinolaryngol Head & Neck Surg, Varese, Italy

[6] Univ Padua, Dept Neurosci, Sect Otorhinolaryngol Head & Neck Surg, Padua, Italy

[7] UCL, Canc Res UK, London, England

[8] UCL, UCL Canc Trials Ctr, London, England

[9] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Unit Otorhinolaryngol Head & Neck Surg, Brescia, Italy

[10] Lebanese Amer Univ, Dept Otolaryngol Head & Neck Surg, Beirut, Lebanon

[11] Stanford Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Rhinol & Endoscop Skull Base Surg, Palo Alto, CA 94304 USA

[12] Med Univ Innsbruck, Dept Otorhinolaryngol, Innsbruck, Austria

[13] Univ Pisa, Dept Translat Res, Pisa, Italy

[14] Univ Insubria, Unit Pathol, ASST Sette Laghi, Varese, Italy

[15] Univ Brescia, ASST Spedali Civili, Dept Mol & Translat Med, Pathol Unit, Brescia, Italy

[16] Univ Southampton, Fac Med, Canc Sci Unit, Southampton, Hants, England

[17] Univ Coll London Hosp NHS Trust, Royal Natl ENT Hosp, London, England

[18] Univ Coll London Hosp NHS Trust, Head & Neck Ctr, London, England

[19] Univ Med Ctr Hamburg Eppendorf, Hubertus Wald Tumorzentrum, Dept Oncol Haematol & Bone Marrow Transplantat, Sect Pneumol, Hamburg, Germany

[20] Univ Coll London Hosp NHS Trust, Head & Neck Ctr, London, England

[21] Univ Manchester, Div Dent, Manchester, Lancs, England

[22] Christie NHS Fdn Trust, Dept Clin Oncol, Manchester, Lancs, England

[23] Univ Liverpool, Liverpool Head & Neck Ctr, Liverpool, Merseyside, England

[24] Univ Chinese Acad Sci, Shanghai Inst Nutr & Hlth, CAS Key Lab Computat Biol, Shanghai, Peoples R China

[25] Univ Pittsburgh, Dept Otolaryngol, Med Ctr, Pittsburgh, PA 15260 USA

[26] Charles Univ Prague, Fac Med, Fingerland Dept Pathol, Hradec Kralove, Czech Republic

[27] Univ Hosp, Hradec Kralove, Czech Republic

[28] Univ Pittsburgh, Med Ctr, Ctr Cranial Base Surg, Pittsburgh, PA USA

[29] Beaumont Hosp, Dept Otolaryngol Head & Neck Surg, Dublin, Ireland

[30] Royal Coll Surgeons Ireland, Dublin, Ireland

[31] Johns Hopkins Sch Med, Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA

[32] Johns Hopkins Univ, Sch Med, Dept Neurosurg, Baltimore, MD 21205 USA

[33] Johns Hopkins Univ, Sch Med, Dept Oncol, Baltimore, MD 21205 USA

[34] Natl Inst Deafness & Other Commun Disorders, Sinonasal & Skull Base Tumor Program, Head & Neck Surg Branch, NIH, Bethesda, MD USA

[35] Stanford Univ, Sch Med, Dept Radiat Oncol, Palo Alto, CA 94304 USA

[36] Inst Invest Sanitaria Principado Asturias, Dept Head & Neck Oncol, Oviedo, Spain

[37] Univ Brescia, Dept Med & Surg Special Radiol Sci & Publ Hlth, Med Oncol, Brescia, Italy

[38] Univ Coll London Hosp NHS Trust, Dept Histopathol, London, England

[39] City Hope Med Ctr, Dis Team Alignment Head & Neck, Duarte, CA USA

来源：

JOURNAL OF NEUROLOGICAL SURGERY PART B-SKULL BASE | 2023年 / 84卷 / 04期

基金：

美国国家卫生研究院;

关键词：

sinonasal mucosal melanoma; TNM; immunotherapy; immune checkpoint blockade; immune checkpoint inhibitors ipilimumab; MUCOSAL MELANOMA; PEMBROLIZUMAB; RADIOTHERAPY; IPILIMUMAB; RESECTION; EXPERIENCE; EFFICACY;

D O I：

10.1055/s-0042-1750178

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objectives Sinonasal mucosal melanoma (SNMM) is an extremely rare and challenging sinonasal malignancy with a poor prognosis. Standard treatment involves complete surgical resection, but the role of adjuvant therapy remains unclear. Crucially, our understanding of its clinical presentation, course, and optimal treatment remains limited, and few advancements in improving its management have been made in the recent past. Methods We conducted an international multicenter retrospective analysis of 505 SNMM cases from 11 institutions across the United States, United Kingdom, Ireland, and continental Europe. Data on clinical presentation, diagnosis, treatment, and clinical outcomes were assessed. Results One-, three-, and five-year recurrence-free and overall survival were 61.4, 30.6, and 22.0%, and 77.6, 49.2, and 38.3%, respectively. Compared with disease confined to the nasal cavity, sinus involvement confers significantly worse survival; based on this, further stratifying the T3 stage was highly prognostic ( p < 0.001) with implications for a potential modification to the current TNM staging system. There was a statistically significant survival benefit for patients who received adjuvant radiotherapy, compared with those who underwent surgery alone (hazard ratio [HR] = 0.74, 95% confidence interval [CI]: 0.57-0.96, p = 0.021). Immune checkpoint blockade for the management of recurrent or persistent disease, with or without distant metastasis, conferred longer survival (HR = 0.50, 95% CI: 0.25-1.00, p = 0.036). Conclusions We present findings from the largest cohort of SNMM reported to date. We demonstrate the potential utility of further stratifying the T3 stage by sinus involvement and present promising data on the benefit of immune checkpoint inhibitors for recurrent, persistent, or metastatic disease with implications for future clinical trials in this field.

引用

页码：307 / 319

页数：13

共 13 条

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