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Clavero-Rovira L, Gómez-Tomás Á, Bassas-Freixas P, Bodet D, Ferrer B, Hernández-Losa J, Muñoz-Couselo E, Pérez-Benavente A, García-Patos V, Ferrándiz-Pulido C. Mucosal Melanoma Clinical Management and Prognostic Implications: A Retrospective Cohort Study. Cancers (Basel) 2024; 16:227. [PMID: 38201654 PMCID: PMC10778057 DOI: 10.3390/cancers16010227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/22/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
Mucosal melanoma (MM) is an uncommon melanoma subtype affecting mucosal surfaces of the head and neck, anorectal region, and vulvovaginal area. We aimed to present our experience at a tertiary-level hospital regarding MM diagnosis, management, monitoring of progression, mutations, and outcome predictors. We performed a registry-based cohort study including MM cases diagnosed from 2012 to 2022 and retrospectively characterized somatic mutations on BRAF, NRAS and c-KIT. We employed Kaplan-Meier curves, log-rank tests, and Cox regression analysis to explore prognostic factors and survival outcomes in a cohort of 35 patients, mainly women (63%) with a median age of 70 years. Predominantly, MM occurred in the vulvovaginal region (48.6%). At diagnosis, 28.6% had lymph node involvement, and 31.4% also had distant metastasis. Mutations in BRAF and c-KIT were identified in 3/35 (9%) and 2/6 patients (33%), respectively. Surgery was performed in 71.4% of patients, and most received systemic treatment (65.7%). Lower disease stage, thinner Breslow depth, and surgical resection were associated with improved overall survival. Notably, age, sex, radiotherapy, and BRAF mutant status did not affect survival. Standard management typically involves immunotherapy. Cases with BRAF or c-KIT mutations may be considered for targeted therapies. Unfortunately, MM prognosis remains unfavorable, with a less than 50% survival rate at 2 years.
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Affiliation(s)
- Laia Clavero-Rovira
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
| | - Álvaro Gómez-Tomás
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
| | - Patricia Bassas-Freixas
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
| | - Domingo Bodet
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
| | - Berta Ferrer
- Department of Pathology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (B.F.); (J.H.-L.)
| | - Javier Hernández-Losa
- Department of Pathology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (B.F.); (J.H.-L.)
| | - Eva Muñoz-Couselo
- Department of Oncology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain;
| | - Assumpció Pérez-Benavente
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain
| | - Vicente García-Patos
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
| | - Carla Ferrándiz-Pulido
- Department of Dermatology, University Hospital Vall d’Hebron, 08035 Barcelona, Spain; (L.C.-R.); (Á.G.-T.); (P.B.-F.); (D.B.); (V.G.-P.)
- Facultad de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain;
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