The prognostic impact of the anatomical sites in the ‘head and neck melanoma’

Abstract

Cutaneous melanoma is a malignant neoplasia with several demographic and histopathological prognostic factors. Many studies stress that the head and neck region has a worse prognosis compared with other localizations, but the reasons for this worse prognosis are unclear. Therefore, the aim of our study is to analyse the poor prognosis of head and neck melanoma (HNM) with respect to the other anatomical sites, considering the face and neck (F&N) and the scalp separately. We carried out a retrospective analysis of 757 melanoma patients. In particular, we studied the prognostic impact of different melanoma skin localizations (head and neck, trunk, upper extremities and lower extremities). Afterwards, we divided HNM into two subgroups, F&N and scalp, to evaluate their impact in the HNM prognosis. Data showed a significantly lower 5-year overall survival probability for HNM (78.9 versus 93.1% for other body sites; P=0.05). Moreover, on analysing the two anatomical areas considered among HNM, we observed a 5-year overall survival of 81.8% for F&N and 66.7% for scalp. HNM has different and worse prognostic features with respect to other sites, but this trend is not only because of scalp melanoma but is also determined by F&N melanoma, which we believe to be underestimated until now.

Effect of time to sentinel-node biopsy on the prognosis of cutaneous melanoma

“…Location on head and neck and, to a lesser extent, on acral sites was associated with worse MSS and DFS, findings that are consistent with previous reports[11, 15]. …”

Primary cutaneous melanoma of the scalp: Patterns of recurrence

“…Consistently, all of the rates of local recurrence for scalp melanoma (Table ) are relatively high when compared to other sites within the head and neck region and the trunk/extremities . Most studies, including the SEER analysis by Lachiewicz et al, have combined melanomas of the scalp with those in the neck or other sites(back/arm/neck/scalp—BANS) .…”

“…Cutaneous melanoma arising on the scalp is reported to have a worse 5‐year disease free survival (DFS) and a higher loco‐regional recurrence rate when compared with melanomas arising on the face and neck, even when statistically controlling for Breslow thickness and ulceration . The precise mechanism underpinning this phenomenon remains unclear.…”

“…The precise mechanism underpinning this phenomenon remains unclear. Most published series and registries integrate the outcomes of scalp melanoma with other anatomical sites, particularly the neck . To date, there are three analyses focusing on the patterns of recurrence for primary cutaneous scalp melanoma in the literature .…”

PET–BT incelenmesi yapılan melanom hastalarının retrospektif analizi

“…Yakın zamanda bazı çalışmalarda da değinildiği gibi kendi hastalarımızda da bu bölge çoğunlukla orta hat ve sol taraf olarak bulunmuştur [8][9] . Saçlı deri ve boyun melanomlarında diğer vücut tutulum alanlarına göre beklenen 5 yıllık sağ kalım oranı düşüktür 10 . Bu bilgiyle uyumlu olarak, saptanan 4 saçlı deri melanom hastasının tamamında uzak metastaz saptanmıştır.…”