MALIGNANT MELANOMATA ARISING IN NASAL MUCOUS-MEMBRANE

All papers published on mucosal melanoma in recent years include tumors arising in the paranasal sinuses and oral cavity. The latter confuse the issue since over 35% present with cervical node metastases and this reflects the 5 yr survival rate of 20%. Salvage rates for 5 yr vary from 6-17% in these reports but it is not possible to extrapolate figures for the nasal passages alone. At 3 years, 10 patients in the present group of 40 were alive and free from disease (47.4%) but this was reduced at 11 at 5 yr, a figure of 27.5%, which includes 3 patients who died of cardiovascular accidents but without postmortem evidence of freedom from melanomas. Although such figures compare unfavorably with skin malignant melanoma, 77% at 5 yr when nodes were uninvolved, they are better than popularly supposed. Future success in means of stimulating individual immunological defenses may lead to a welcome improvement. Meanwhile, an optimistic attitude combined with a realistic approach to treatment may be justified.