Outcomes of Curative‐Intent Endoscopic Resection Combined With Adjuvant Immune Checkpoint Inhibition for Resectable Sinonasal Mucosal Melanoma

Abstract

ABSTRACT Background Evidence for adjuvant immune checkpoint inhibitor (ICI) therapy after curative‐intent resection of sinonasal mucosal melanoma (SNMM) is limited. Methods We retrospectively reviewed 11 patients with resectable N0M0 SNMM who underwent curative‐intent endoscopic resection followed by adjuvant ICI. Outcomes and immune‐related adverse events (irAEs) were summarized descriptively, and univariable Cox proportional hazards regression was performed as an exploratory analysis to explore potential risk factors. Results The 1‐ and 3‐year overall survival rates were 100.0% and 90.0%; recurrence‐free survival rates were 45.5% and 0%. Any‐grade and grade ≥ 3 irAEs occurred in 8 of 11 patients (72.7%) and 3 patients (27.3%). T4a disease was associated with shorter recurrence‐free survival than T3 disease (hazard ratio, 13.96; 95% confidence interval, 1.24–157.50; p = 0.033). Conclusions Recurrence was frequent and early, whereas overall survival remained preserved. Although efficacy cannot be inferred without a comparator, these data support multicenter evaluation of treatment sequencing and risk stratification.