3c63dee4a80e3ffaad6cfaa41f035a3f 321349.pdf 3c21aec6fdeb5e9df8cf30530295be977fce65d4 321349.pdf 4e3511440867a14885cf79ce9be3e3dd0cf7393bc8edbd946d52075296649b33 321349.pdf Title: Mucosal Melanoma Clinical Management and Prognostic Implications: A Retrospective Cohort Study Subject: 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. 20pt Keywords: mucosal melanoma; somatic mutations; prognostic factors; Breslow depth; immunotherapy; survival outcomes Author: Laia Clavero-Rovira, Álvaro Gómez-Tomás, Patricia Bassas-Freixas, Domingo Bodet, Berta Ferrer, Javier Hernández-Losa, Eva Muñoz-Couselo, Assumpció Pérez-Benavente, Vicente García-Patos and Carla Ferrándiz-Pulido Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Wed Jan 3 11:25:15 2024 CET ModDate: Wed Jan 3 11:32:59 2024 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 15 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1819001 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- FFAYKL+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 YYHNDN+VnURWPalladioL Type 1 Custom yes yes yes 16 0 JAVQZX+URWPalladioL-Bold Type 1 Custom yes yes yes 21 0 WVCBPM+URWPalladioL-Roma Type 1 Custom yes yes yes 27 0 DKTVHS+URWPalladioL-Ital Type 1 Custom yes yes yes 32 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 49 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 69 0 HCPSKZ+CMSY10 Type 1 Builtin yes yes yes 77 0 EMIGHJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 92 0 EMIGHL+PalatinoLinotype TrueType WinAnsi yes yes no 95 0 EMIGHN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 98 0 EMIHEK+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 101 0 EMIGHJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 122 0 EMIGHL+PalatinoLinotype TrueType WinAnsi yes yes no 125 0 EMIGHN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 128 0 KGSZMU+VnURWPalladioL-Italic Type 1 Custom yes yes yes 148 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-01-31 04:18:23 CET RepresentationInformation: 321349.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-01-30 12:51:11 CET Size: 1819001 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 405 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design and Data Source Destination: subsection.2.1 Item: Title: Statistical Analysis Destination: subsection.2.2 Item: Title: Results Destination: section.3 Children: Item: Title: Characteristics of Patients and Tumors at Baseline Destination: subsection.3.1 Item: Title: Breslow and Staging Destination: subsection.3.2 Item: Title: Mutations Destination: subsection.3.3 Item: Title: Management Destination: subsection.3.4 Item: Title: Survival Outcomes Destination: subsection.3.5 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Mucosal Melanoma Clinical Management and Prognostic Implications: A Retrospective Cohort Study Author: Laia Clavero-Rovira, Álvaro Gómez-Tomás, Patricia Bassas-Freixas, Domingo Bodet, Berta Ferrer, Javier Hernández-Losa, Eva Muñoz-Couselo, Assumpció Pérez-Benavente, Vicente García-Patos and Carla Ferrándiz-Pulido Subject: 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. 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