Abstract 428P
Background
Nasopharyngeal malignant melanoma (NPM) is an exceedingly rare type of head and neck mucosal melanoma with poor prognosis. NPM is detected at advanced stages because of the anatomic locations involved, the scarcity of early clinical clues and being often amelanotic. Surgical excision of NPM is considered the therapeutic gold standard. However it is difficult to control surgical margins and extensive disfiguring surgical resection is required. While immunotherapy is still under evaluation. We aimed to evaluate the survival outcomes of surgical management for malignant NPM in the era of immunotherapy.
Methods
Using the Surveillance, Epidemiology, and End Results (SEER) database, we included 611 malignant NPM cases diagnosed from 2000-2021 and reviewed their clinical-pathological characteristics including gender, age, race, residence, income and marital status. According to the approval of immune checkpoint inhibitors (ICIs) in 2011, the era was divided into the non-ICIs era (2000-2010) and the ICIs era (2011-2021).
Results
Surgical management during the ICIs era had improved the 5-year relative survival compared to surgical management before the ICIs era (49.3% and 37.5% respectively; P=0.035). Caucasians had better 5-year relative survival outcome compared to African-Americans and other races (39.3%, 33.8% and 36.7% respectively; P=0.022). There was no significant difference in the 5-year relative survival outcome regarding single, married, divorced and widowed patients (44.8%, 37.9%, 31.4% and 41.1% respectively; P=0.091). Males and females had quite similar 5-year relative survival (36.4%, 40.8% respectively; P=0.758). Performing COX-regression model for age, race, gender, marital status, income and residence showed race (HR=2.015, 95% CI: 1.165-3.484; P=0.012) was significantly associated with the survival outcome.
Conclusions
The results of this study showed promising survival outcomes for patients with malignant NPM who underwent surgery in the immunotherapy era compared to surgery before the immunotherapy era which highlights the necessity of further evaluation of adjuvant immunotherapy as the modality of choice for malignant NPM.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.