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Head and neck melanoma in the sentinel lymph node era
Doreen M Agnese1, Rebecca Maupin, Bryan Tillman
1Department of Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University, 410 W 10th Avenue, Columbus, OH 43210, USA. Doreen.Agnese@osumc.edu
Archives of Otolaryngology--Head & Neck Surgery
|November 21, 2007
Summary
Head and neck melanoma (HNM) patients, often older males, do not experience worse outcomes compared to melanomas at other sites (OMS) when treated with sentinel lymph node (SLN) biopsy.
Area of Science:
- Dermatology
- Surgical Oncology
- Oncology
Background:
- Melanoma of the head and neck (HNM) presents unique challenges in diagnosis and treatment.
- The advent of sentinel lymph node (SLN) biopsy has refined staging and management protocols for melanoma.
- Comparative outcome data for HNM versus melanomas at other sites (OMS) in the SLN era is crucial.
Purpose of the Study:
- To compare the clinical characteristics and patient outcomes of head and neck melanoma (HNM) against melanomas at other sites (OMS).
- To evaluate if HNM confers a poorer prognosis in the context of sentinel lymph node biopsy management.
Main Methods:
- Prospective data collection from 1994 to 2004 at a tertiary referral center.
- Analysis of 755 patients who underwent sentinel lymph node (SLN) biopsy for melanoma.
- Statistical comparison using Fisher test, paired t test, and chi-squared test for HNM versus OMS patient cohorts.
Main Results:
- Head and neck melanoma (HNM) was diagnosed in 17.4% of patients, predominantly affecting older males.
- HNM cases showed a higher incidence of lentigo maligna and lower rates of superficial spreading melanoma compared to OMS.
- Despite more SLNs being harvested in HNM, positive SLN rates were lower, and recurrence and survival rates were comparable to OMS.
Conclusions:
- Head and neck melanoma (HNM) patients are typically older males, with distinct histopathological features.
- The sentinel lymph node biopsy era shows no evidence of a poorer outcome for HNM compared to melanomas at other sites (OMS).
- SLN biopsy is an effective staging tool for HNM, yielding comparable prognostic information to OMS.
