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Primary Mucosal Melanomas of the Head and Neck

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Head and Neck Cancer

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Abstract

Mucosal melanomas of the head and neck are a rare disease of dismal prognosis. They account for less than 1 % of all cancers, less than 4 % of all melanomas, and more than half of all mucosal melanomas. Five-year survival is about 20–30 %, mainly because of deaths from distant metastases. Mucosal melanomas of the head and neck deserve central pathology reviews and case discussions within multidisciplinary rare disease networks, aware of all the diagnostic and therapeutic challenges. Early diagnosis followed by surgical excision remains the mainstay of treatment, and postoperative radiation therapy is often recommended. Current controversies include the role of minimal invasive endoscopic approaches, their challenges in terms of margin assessment, and radiation therapy dose. As for the modalities of radiation therapy, the current level of evidence pleads in favor of optimized tridimensional conventionally fractionated radiation therapy. However, technological advances suggest that carbon therapy might be preferred to proton therapy because of an expected better biological efficacy and charged particle therapy (proton or carbon therapy) to photon-based irradiation because of dose distributions and safer ability toward hypofractionation. The domain of medical oncology and genetic research may provide further clues, especially in light of benefits noted of KIT inhibitors and the proportion of mucosal melanomas with this genetic aberration. Adequate methodology needs to be developed for rare diseases with specific therapeutic challenges, and patient associations, patient-reported outcomes, and quality-adjusted life-years (QALY) should be part of the assessment of the treatment modalities.

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Centre Lacassagne, 227 Av de la Lanterne, Nice, 06200, France

    Juliette Thariat MD, PhD

  2. REFCOR (Réseau d’Expertise Français des Cancers ORL Rares) and Rare Cancer Network, Paris, France

    Juliette Thariat MD, PhD & Anne-Catherine Baglin MD

  3. Department of Pathology, Hôpital Lariboisière, Paris, France

    Anne-Catherine Baglin MD

  4. Department of Interventional Imaging and Radiodiagnostics, Polyclinique Les Fleurs, Ollioules, France

    Pierre Yves Marcy MD

  5. Department of Head and Neck, Gustave Roussy, Villejuif, France

    Caroline Even MD & Antoine Moya-Plana MD

  6. Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan

    Yusuke Demizu MD

  7. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Adam S. Garden MD

  8. Department of Radiotherapy, University Hospital “Maggiore della Carità”, Novara, Italy

    Marco Krengli MD

  9. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Michael A. Postow MD

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  1. Juliette Thariat MD, PhD
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  2. Anne-Catherine Baglin MD
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  3. Pierre Yves Marcy MD
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  4. Caroline Even MD
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  5. Antoine Moya-Plana MD
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  6. Yusuke Demizu MD
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  7. Adam S. Garden MD
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  9. Michael A. Postow MD
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Correspondence to Juliette Thariat MD, PhD .

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Editors and Affiliations

  1. Department of Radio-Oncology, Genolier Swiss Medical Network, Genolier, Switzerland

    Jacques Bernier

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Thariat, J. et al. (2016). Primary Mucosal Melanomas of the Head and Neck. In: Bernier, J. (eds) Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-27601-4_37

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  • DOI: https://doi.org/10.1007/978-3-319-27601-4_37

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