Risk and Survival of Patients with Head and Neck Cutaneous Melanoma: National Perspective

Al‐Qurayshi, Zaid; Hassan, Mohamed; Srivastav, Sudesh; Sperry, Steven M.; Pagedar, Nitin A.; Hamner, John B.; Kandil, Emad

doi:10.1159/000458530

Cited by 24 publications

(29 citation statements)

References 24 publications

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“…A National Cancer Database study including 20,322 head and neck cutaneous melanoma cases found an incidence of positive margins of 5% (1,022/ 20,062). 27 Although the study by Al-Qurayshi et al did not report on predictors of positive margins, it provides evidence that the incidence of positive margins is lower than the 10% found in this systematic review. This is most likely because published studies include patients with higher risk disease.…”

Section: Discussioncontrasting

confidence: 54%

Considerations for Timing of Defect Reconstruction in Cutaneous Melanoma of the Head and Neck

et al. 2019

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The objective of this study is to identify the incidence and characteristics of cases with positive margins on wide local excision for cutaneous melanoma of the head and neck (CMHN) and therefore provide a potential basis for selectively delaying reconstruction pending final histological clearance of melanoma. A systematic review of English language articles was performed on studies retrieved from PubMed and Web of Science. Original investigations published between July 1999 and June 2018 reporting on margin status of CMHN wide local excision specimens were included in the review. The incidence of positive margins after definitive resection for cutaneous melanoma in the literature ranges from 6 to 20.9%. The incidence is higher in cases of advanced patient age, diagnosis by shave biopsy, lentigo maligna melanoma subtype, desmoplastic subtype, tumor thickness, and ulceration. Delayed reconstruction remains the most oncologically sound decision, allowing for interpretation of margin status on paraffin-embedded tissue sections. However, resection and the resultant defect closure in a single stage is more expedient and potentially a more efficient use of resources. The risk–benefit ratio of immediate versus delayed reconstruction must be considered for each case. The incidence of positive margins is higher in cases of advanced patient age, diagnosis by shave biopsy, lentigo maligna melanoma subtype, desmoplastic subtype, increasing tumor thickness, and the presence of ulceration; delayed reconstruction should be strongly considered in these cases.

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Section: Discussioncontrasting

confidence: 54%

Considerations for Timing of Defect Reconstruction in Cutaneous Melanoma of the Head and Neck

et al. 2019

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“…Distant metastases (M1) were detected in 31 patients before treatment administration and in 15 patients while treated with CPI. Altogether, lungs metastases (29 patients) were most common followed by unresectable neck lymph nodes (20), soft tissue (15), central nervous system (13), hepatic (11), adrenal (6), kidneys (5), spleen (4), thyroid (3), gastrointestinal (3), muscles (2), pancreas (1) and ovary (1). Non-resectable neck lymph nodes and lungs metastases had the best ORR (70% and 58.6%, respectively) while brain and bone metastases had the worst ORR (7% and 0%, respectively) ( Table 2).…”

Section: Plos Onementioning

confidence: 99%

“…Cutaneous melanoma is more prevalent in the head and neck region relative to other body sites. Head and neck melanoma (HNM) is more likely to present with aggressive clinicopathological features with deeper Breslow thickness and advanced clinical stage [1]. However, a survival difference is still to be clarified [2].…”

Section: Introductionmentioning

confidence: 99%

Checkpoint inhibitors: Better outcomes among advanced cutaneous head and neck melanoma patients

et al. 2020

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The aim of this study was to investigate if the treatment outcomes of checkpoint inhibitors (CPI) in patients with advanced-stage skin head and neck melanoma (HNM) differs from outcomes in patients with non-HNM. Design A retrospective cohort study of patients with unresectable AJCC stage III and stage IV, who received CPI between 2010 and 2017. Participants Overall, 122 unresectable AJCC stage III and metastatic stage IV melanoma adult patients were treated with CPI during the study period (consecutive patients). The HNM group of patients was comparable with limbs and trunk melanoma group except different distant metastatic (M1a/b/c/d) pattern (p = 0.025). Main outcomes Comparison of overall survival and clinical response to CPI in patients with advanced-stage skin melanoma of the head and neck with non-HNM. Results We analyzed 38 patients with melanoma arising in the head and neck skin regions, 33 with melanoma of limbs and 51 with trunk melanoma. Most of the head and neck patients were men (89.5%), the average age of melanoma diagnosis was 61.4±16.7 years (range 16.4-85.6). More than a third of HNM group of patients (36.8%) were 70 years and older. Overall response rate (ORR) to CPI was 50% (CR 31.6% and PR 18.4%) in the head and neck

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“…Our study included patients with head and neck melanoma (HNM) followed in the 5-year period from diagnosis. A total of 116 patients with HNM makes up 14.99% of all melanoma patients in the same time period, which represents a lower prevalence of HNM than in other studies [7]. HNM is more common in males (57.76%) and people older than 50 years (77.59%), but neither of the abovementioned predictors affects survival.…”

Section: Discussionmentioning

confidence: 79%

“…The median age at diagnosis was about 60 years, but a quarter of patients were younger than 45 [7]. Early diagnosis and adherence to established treatment guidelines significantly affect survival in these patients [8].…”

Section: Introductionmentioning

confidence: 99%

Head and neck cutaneous melanoma: 5-year survival analysis in a Serbian university center

Višnjić

Kovačević

Velickov³

et al. 2020

World J Surg Onc

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Background Head and neck melanoma (HNM) is specific from the anatomical and etiopathogenetic aspects. In addition to morphopathological parameters, rich vascularization and lymphatic drainage of the head and neck affect the occurrence of lymphogenic and hematogenous metastases, as well as the metastases on both sides of the neck. Methods A retrospective cross-sectional study included cutaneous melanoma patients who underwent surgery at a clinical center over a 10-year period. The clinical follow-up was at least 60 months. The Kaplan-Meier method was used for the survival analysis. The predictor effect of certain independent variables on a given dichotomous dependent variable (survival) was measured by the Cox regression analysis. Results The analysis of demographic and clinical characteristics of 116 patients with HNM revealed that there was no statistically significant difference in age and gender in the total sample. Thirty-three (28.45%) patients were already in stage III or IV of the disease at the first examination, which affected the overall survival rate. The overall 5-year survival was 30.2%. No statistically significant difference in 5-year survival was found in relation to age and location. The period without melanoma progression decreased progressively in the advanced stage. Forty-nine patients (42%) underwent surgery for lymphogenic metastases in the parotid region and/or neck during the follow-up. Conclusions Patients with HNM included in this study frequently presented an advanced stage of the disease at the first examination, which is reflected in a low rate of 5-year survival. Early diagnosis and adequate primary treatment can ensure longer survival.

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Risk and Survival of Patients with Head and Neck Cutaneous Melanoma: National Perspective

Cited by 24 publications

References 24 publications

Considerations for Timing of Defect Reconstruction in Cutaneous Melanoma of the Head and Neck

Considerations for Timing of Defect Reconstruction in Cutaneous Melanoma of the Head and Neck

Checkpoint inhibitors: Better outcomes among advanced cutaneous head and neck melanoma patients

Head and neck cutaneous melanoma: 5-year survival analysis in a Serbian university center

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