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Updated: Jun 8, 2026
A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
Evolving treatment strategies in thin cutaneous head and neck melanoma: 1 institution's experience
James J Jaber1, Joseph I Clark, Kamil Muzaffar
1Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
Background:
Although existing melanoma literature provides recommendations for thinner lesions (≤1 mm) within a heterogeneous population, a focus on the head and neck group is less pervasive.
Methods:
The records of 49 node-negative individuals with thin head and neck melanoma that underwent surgical intervention ± sentinel lymph node (SLN) biopsy were reviewed.
Results:
A significant increased Breslow thickness and mitotic rate, and a trend toward significance in Clark level ≥ IV were shown in patients that underwent an SLN biopsy versus those that did not. The total number of positive biopsies was 2 (5%). In our subset analysis using the modified American Joint Committee on Cancer recommendations by Wong and colleagues, the incidence of positive SLN biopsy would have increased to 11%.
Conclusion:
We advocate performing an SLN biopsy in thin head and neck melanomas for primary tumors > 0.75 mm, regardless of "high-risk" features as described by Wong and colleagues.
Insights
Sentinel lymph node biopsy is recommended for thin head and neck melanomas over 0.75 mm. This approach aids in detecting metastasis, improving patient management for this specific melanoma subtype.
Area of Science:
- Dermatology
- Surgical Oncology
- Oncology
Background:
- Existing melanoma literature lacks specific guidance for head and neck melanomas.
- Recommendations for thinner lesions (≤1 mm) are often based on heterogeneous populations.
Purpose of the Study:
- To evaluate the utility of sentinel lymph node (SLN) biopsy in thin head and neck melanomas.
- To determine optimal criteria for SLN biopsy in this patient group.
Main Methods:
- Retrospective review of 49 node-negative patients with thin head and neck melanoma.
- Analysis of surgical intervention with or without SLN biopsy.
Main Results:
- Patients undergoing SLN biopsy showed increased Breslow thickness and mitotic rate.
- A trend towards higher Clark level (≥ IV) was observed in the SLN biopsy group.
- The overall positive SLN biopsy rate was 5% (2/49), potentially increasing to 11% with modified criteria.
Conclusions:
- Performing SLN biopsy for thin head and neck melanomas with primary tumors > 0.75 mm is advocated.
- SLN biopsy is recommended irrespective of other "high-risk" features.
- This approach may improve staging accuracy and guide further treatment decisions.
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