Optimal multidisciplinary treatment of oral cavity mucosal melanoma: Outcome analysis in a case series

Salvatore Pisconti, Matteo Favia, Giuseppina Della Vittoria Scarpati, Manuel Conson, Mario Giuliano, Franco Ionna, Francesco Longo, Bonamonte Domenico, Eugenio Maiorano, Gianfranco Favia

Research output: Contribution to journalArticle

Abstract

cavity mucosal melanomas (OCMM) represent only 3% of all malignant melanomas. Surgery is the mainstay of treatments and it is often followed by adjuvant radiotherapy. The role of adjuvant immunotherapy and/or chemotherapy is still debated and to date neither treatment is routinely used. From January 1990 to January 2010, we have collected from our database data of 20 patients with a histologically proven diagnosis of OCMM. Upfront surgery, followed by adjuvant radiotherapy was performed in 16/20 (80%) patients. Immunohistochemical analysis was carried out on all tissue samples and the following markers were assessed: Ki-67, HMG-45, Melan-A, S-100, CD31, CD35, CD20, CD21, and CD3. Although Ki-67, HMG-45, Melan-A, and S-100 were assessed in tumor cells, the analysis of CD31, CD21, CD20, CD3, and CD35 was carried out on the tumor-infiltrating lymphocytes. Patient outcome was analyzed and associated with clinical and Immunohistochemical tumor characteristics. The median overall survival (OS) was 12 months, with a 2-year OS rate of 30%. The median progression-free survival (PFS) was 9 months, with a 2-year PFS rate of 25%. Grade of lymphocyte infiltration (CD20 and CD3 expression) correlated strongly with prognosis. Interestingly, overexpression of CD21 along with downregulation of CD31 was significantly associated with better OS and PFS, whereas the reversal features correlated with a poor prognosis. Our report shows that patients affected by OCMM have a poor prognosis despite the administration of multimodal treatments. Moreover, our analysis suggests that the evaluation of several biomarkers, especially in tumor-infiltrating lymphocytes, may identify categories of patients with distinct immune response against the tumor and possibly different treatment response and prognosis. Anti-Cancer Drugs 28:327-334.

Original languageEnglish
Pages (from-to)327-334
Number of pages8
JournalAnti-Cancer Drugs
Volume28
Issue number3
DOIs
Publication statusPublished - 2017

Fingerprint

Mouth
Melanoma
MART-1 Antigen
Disease-Free Survival
Tumor-Infiltrating Lymphocytes
Adjuvant Radiotherapy
Neoplasms
Survival Rate
Therapeutics
Combined Modality Therapy
Survival
Immunotherapy
Down-Regulation
Biomarkers
Databases
Lymphocytes
Drug Therapy
Pharmaceutical Preparations

Keywords

  • adjuvant therapy
  • CD20
  • CD21
  • CD3
  • CD31
  • immunotherapy
  • oral cavity mucosal melanoma

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Cancer Research
  • Pharmacology (medical)

Cite this

Optimal multidisciplinary treatment of oral cavity mucosal melanoma : Outcome analysis in a case series. / Pisconti, Salvatore; Favia, Matteo; Scarpati, Giuseppina Della Vittoria; Conson, Manuel; Giuliano, Mario; Ionna, Franco; Longo, Francesco; Domenico, Bonamonte; Maiorano, Eugenio; Favia, Gianfranco.

In: Anti-Cancer Drugs, Vol. 28, No. 3, 2017, p. 327-334.

Research output: Contribution to journalArticle

Pisconti, S, Favia, M, Scarpati, GDV, Conson, M, Giuliano, M, Ionna, F, Longo, F, Domenico, B, Maiorano, E & Favia, G 2017, 'Optimal multidisciplinary treatment of oral cavity mucosal melanoma: Outcome analysis in a case series', Anti-Cancer Drugs, vol. 28, no. 3, pp. 327-334. https://doi.org/10.1097/CAD.0000000000000454
Pisconti, Salvatore ; Favia, Matteo ; Scarpati, Giuseppina Della Vittoria ; Conson, Manuel ; Giuliano, Mario ; Ionna, Franco ; Longo, Francesco ; Domenico, Bonamonte ; Maiorano, Eugenio ; Favia, Gianfranco. / Optimal multidisciplinary treatment of oral cavity mucosal melanoma : Outcome analysis in a case series. In: Anti-Cancer Drugs. 2017 ; Vol. 28, No. 3. pp. 327-334.
@article{cf34118030854164b251f786d1654a01,
title = "Optimal multidisciplinary treatment of oral cavity mucosal melanoma: Outcome analysis in a case series",
abstract = "cavity mucosal melanomas (OCMM) represent only 3{\%} of all malignant melanomas. Surgery is the mainstay of treatments and it is often followed by adjuvant radiotherapy. The role of adjuvant immunotherapy and/or chemotherapy is still debated and to date neither treatment is routinely used. From January 1990 to January 2010, we have collected from our database data of 20 patients with a histologically proven diagnosis of OCMM. Upfront surgery, followed by adjuvant radiotherapy was performed in 16/20 (80{\%}) patients. Immunohistochemical analysis was carried out on all tissue samples and the following markers were assessed: Ki-67, HMG-45, Melan-A, S-100, CD31, CD35, CD20, CD21, and CD3. Although Ki-67, HMG-45, Melan-A, and S-100 were assessed in tumor cells, the analysis of CD31, CD21, CD20, CD3, and CD35 was carried out on the tumor-infiltrating lymphocytes. Patient outcome was analyzed and associated with clinical and Immunohistochemical tumor characteristics. The median overall survival (OS) was 12 months, with a 2-year OS rate of 30{\%}. The median progression-free survival (PFS) was 9 months, with a 2-year PFS rate of 25{\%}. Grade of lymphocyte infiltration (CD20 and CD3 expression) correlated strongly with prognosis. Interestingly, overexpression of CD21 along with downregulation of CD31 was significantly associated with better OS and PFS, whereas the reversal features correlated with a poor prognosis. Our report shows that patients affected by OCMM have a poor prognosis despite the administration of multimodal treatments. Moreover, our analysis suggests that the evaluation of several biomarkers, especially in tumor-infiltrating lymphocytes, may identify categories of patients with distinct immune response against the tumor and possibly different treatment response and prognosis. Anti-Cancer Drugs 28:327-334.",
keywords = "adjuvant therapy, CD20, CD21, CD3, CD31, immunotherapy, oral cavity mucosal melanoma",
author = "Salvatore Pisconti and Matteo Favia and Scarpati, {Giuseppina Della Vittoria} and Manuel Conson and Mario Giuliano and Franco Ionna and Francesco Longo and Bonamonte Domenico and Eugenio Maiorano and Gianfranco Favia",
year = "2017",
doi = "10.1097/CAD.0000000000000454",
language = "English",
volume = "28",
pages = "327--334",
journal = "Anti-Cancer Drugs",
issn = "0959-4973",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Optimal multidisciplinary treatment of oral cavity mucosal melanoma

T2 - Outcome analysis in a case series

AU - Pisconti, Salvatore

AU - Favia, Matteo

AU - Scarpati, Giuseppina Della Vittoria

AU - Conson, Manuel

AU - Giuliano, Mario

AU - Ionna, Franco

AU - Longo, Francesco

AU - Domenico, Bonamonte

AU - Maiorano, Eugenio

AU - Favia, Gianfranco

PY - 2017

Y1 - 2017

N2 - cavity mucosal melanomas (OCMM) represent only 3% of all malignant melanomas. Surgery is the mainstay of treatments and it is often followed by adjuvant radiotherapy. The role of adjuvant immunotherapy and/or chemotherapy is still debated and to date neither treatment is routinely used. From January 1990 to January 2010, we have collected from our database data of 20 patients with a histologically proven diagnosis of OCMM. Upfront surgery, followed by adjuvant radiotherapy was performed in 16/20 (80%) patients. Immunohistochemical analysis was carried out on all tissue samples and the following markers were assessed: Ki-67, HMG-45, Melan-A, S-100, CD31, CD35, CD20, CD21, and CD3. Although Ki-67, HMG-45, Melan-A, and S-100 were assessed in tumor cells, the analysis of CD31, CD21, CD20, CD3, and CD35 was carried out on the tumor-infiltrating lymphocytes. Patient outcome was analyzed and associated with clinical and Immunohistochemical tumor characteristics. The median overall survival (OS) was 12 months, with a 2-year OS rate of 30%. The median progression-free survival (PFS) was 9 months, with a 2-year PFS rate of 25%. Grade of lymphocyte infiltration (CD20 and CD3 expression) correlated strongly with prognosis. Interestingly, overexpression of CD21 along with downregulation of CD31 was significantly associated with better OS and PFS, whereas the reversal features correlated with a poor prognosis. Our report shows that patients affected by OCMM have a poor prognosis despite the administration of multimodal treatments. Moreover, our analysis suggests that the evaluation of several biomarkers, especially in tumor-infiltrating lymphocytes, may identify categories of patients with distinct immune response against the tumor and possibly different treatment response and prognosis. Anti-Cancer Drugs 28:327-334.

AB - cavity mucosal melanomas (OCMM) represent only 3% of all malignant melanomas. Surgery is the mainstay of treatments and it is often followed by adjuvant radiotherapy. The role of adjuvant immunotherapy and/or chemotherapy is still debated and to date neither treatment is routinely used. From January 1990 to January 2010, we have collected from our database data of 20 patients with a histologically proven diagnosis of OCMM. Upfront surgery, followed by adjuvant radiotherapy was performed in 16/20 (80%) patients. Immunohistochemical analysis was carried out on all tissue samples and the following markers were assessed: Ki-67, HMG-45, Melan-A, S-100, CD31, CD35, CD20, CD21, and CD3. Although Ki-67, HMG-45, Melan-A, and S-100 were assessed in tumor cells, the analysis of CD31, CD21, CD20, CD3, and CD35 was carried out on the tumor-infiltrating lymphocytes. Patient outcome was analyzed and associated with clinical and Immunohistochemical tumor characteristics. The median overall survival (OS) was 12 months, with a 2-year OS rate of 30%. The median progression-free survival (PFS) was 9 months, with a 2-year PFS rate of 25%. Grade of lymphocyte infiltration (CD20 and CD3 expression) correlated strongly with prognosis. Interestingly, overexpression of CD21 along with downregulation of CD31 was significantly associated with better OS and PFS, whereas the reversal features correlated with a poor prognosis. Our report shows that patients affected by OCMM have a poor prognosis despite the administration of multimodal treatments. Moreover, our analysis suggests that the evaluation of several biomarkers, especially in tumor-infiltrating lymphocytes, may identify categories of patients with distinct immune response against the tumor and possibly different treatment response and prognosis. Anti-Cancer Drugs 28:327-334.

KW - adjuvant therapy

KW - CD20

KW - CD21

KW - CD3

KW - CD31

KW - immunotherapy

KW - oral cavity mucosal melanoma

UR - http://www.scopus.com/inward/record.url?scp=85002488046&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85002488046&partnerID=8YFLogxK

U2 - 10.1097/CAD.0000000000000454

DO - 10.1097/CAD.0000000000000454

M3 - Article

AN - SCOPUS:85002488046

VL - 28

SP - 327

EP - 334

JO - Anti-Cancer Drugs

JF - Anti-Cancer Drugs

SN - 0959-4973

IS - 3

ER -