Surgery Versus Postoperative Radiotherapy For Sinonasal Malignant Melanoma:a Meta-anlysis

Background Sinonasal malignant melanoma is a rare malignancy with poor prognosis, and the effective treatment remains elusive.Objectives This analysis was aimed at exploring whether postoperative radiotherapy confers any survival benefits on sugery alone in the management of Sinonasal malignant melanoma.Methods Published studies were identified through a search in Pubmed, Web of science, Ovid through to December2013. End points evaluated were rates of overall survival (OS), disease-free survival (DFS) and local control(LC).Results A total of19studies were identified, including654patients, of which,313were treated by postoperative radiotherapy, and341patients were treated by surgery. It was indicated that postoperative radiotherapy does not significantly improve OS, including1year OS (relative risk=1.03;95%CI=0.92to1.14; P=0.64),3year OS (relative risk=1.05;95%CI=0.88to1.27; P=0.57) and5year OS (relative risk=1.29;95%CI=0.96to1.72; P=0.09). Similarly, it showed no significant benefits for DFS or LC, including1year DFS (relative risk=0.77;95%CI=0.50to1.18; P=0.23),3year DFS (relative risk=1.17;95%CI=0.66to2.07; P=0.60) and5year DFS (relative risk=0.80;95%CI=0.46to1.39; P=0.44),1year LC (relative risk=1.07;95%CI=0.87to1.32; P=0.54),3year LC (relative risk=1.11;95%CI=0.80to1.56; P=0.53) and5year LC (relative risk=0.86;95%CI=0.52to1.43; P=0.56).Conclusions This meta-analysis provided a summary of all the data currently available, and showed that postoperative radiotherapy does not significantly improve OS, DFS or LC rate of sinonasal malignant melanoma, when compared to surgery alone.