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Sentinel node biopsy in patients with cutaneous melanoma of the head and neck: recurrence and survival study
Fernando Gomez-Rivera1, Alfredo Santillan, Andrea Barber McMurphey
1Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Background:
Controversy remains regarding the benefits of sentinel lymph node (SLN) biopsy for predicting survival in cutaneous melanoma of the head and neck (CMHN).
Methods:
We analyzed the factors associated with the recurrence and survival of CMHN patients treated in our institution.
Results:
One hundred thirteen patients underwent SLN biopsy for CMHN in a 12-year period. SLN identification was successful in 96%, with a median of 3 SLNs per patient. Positive-SLNs were identified in 21%. With a median follow-up of 34 months, 28% recurred. Disease-free survival (DFS) and overall survival (OS) rates were 66% and 78% in patients with SLN-negative, and 39% and 62% in SLN-positive disease. In multivariate analysis, greater Breslow-thickness was associated with decreased DFS rate (HR 2.07, CI 1.04-4.09), and age>60 years (HR 3.53, CI 1.32-9.4) with lower 5-year OS rate.
Conclusion:
Primary tumor thickness and age were associated with decreased survival, whereas SLN status showed a trend for prognostic significance in CMHN.
