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Clinical and histological features of head and neck melanoma: a population-based study in France
1Service de Dermatologie, Hôpital Robert Debré, CHU de Reims, Reims, France.
Background:
Head and neck melanomas (HNMs) account for an increasing proportion of melanomas and have a poor prognosis.
Objectives:
To compare the clinical and histological characteristics of HNMs with those of melanomas at other sites (MOS), and to identify pertinent clinicopathological subgroups of HNM.
Methods:
A retrospective population-based study of incident in situ and invasive melanomas in the period 2004-2011 was performed.
Results:
HNMs represented 26·7% of 1548 melanomas, corresponding to a density ratio of 3·7 between HNMs and MOS. HNMs occurred later than MOS (71·2 vs. 58·4 years; P < 0·01), included a higher proportion of in situ cases (49·6% vs. 13·5%; P < 0·01) and were mainly lentigo malignant melanomas (73·0% vs. 2·6%; P < 0·01). Invasive HNMs included a higher proportion of thick (> 2 mm) tumours [33·7% vs. 24·1% (P = 0·01); mean Breslow thickness: 2·18 vs. 1·77 mm (P = 0·03)] and nodular melanomas (20·1% vs. 12%; P < 0·01). HNMs in the peripheral area of the head and neck differed from those of central location by a younger age of onset (65·2 vs. 72·4 years; P < 0·01), male predominance (64·4% vs. 33·8%; P < 0·01), and higher proportions of invasive (67·2% vs. 42%; P < 0·01) and nodular (15·1% vs. 7·5%; P = 0·01) melanomas.
Conclusions:
HNMs highly differ from MOS, and are clinically and histologically heterogeneous, possibly as a consequence of different patterns of sun exposure. These data could help to improve primary and secondary prevention messages for patients and doctors.
Insights
Head and neck melanomas (HNMs) are distinct from melanomas at other sites (MOS), presenting with unique clinical and histological features. Understanding these differences is crucial for improving prevention and treatment strategies for HNMs.
Area of Science:
- Dermatology
- Oncology
- Epidemiology
Background:
- Head and neck melanomas (HNMs) represent a growing subset of melanomas.
- HNMs are associated with a poorer prognosis compared to melanomas at other sites.
Purpose of the Study:
- To compare the clinical and histological characteristics of HNMs with melanomas at other sites (MOS).
- To identify distinct clinicopathological subgroups within HNMs.
Main Methods:
- A retrospective, population-based study analyzed incident in situ and invasive melanomas between 2004 and 2011.
- Clinical and histological data were compared between HNMs and MOS.
Main Results:
- HNMs constituted 26.7% of all melanomas, with a significantly higher density than MOS.
- HNMs occurred at a later age, had a higher proportion of in situ and lentigo maligna types, and invasive HNMs were thicker and more frequently nodular.
- Peripheral HNMs differed from central HNMs, showing earlier onset, male predominance, and higher rates of invasive and nodular types.
Conclusions:
- HNMs exhibit significant clinical and histological differences from MOS, likely due to varied sun exposure patterns.
- These findings underscore the heterogeneity of HNMs and can inform targeted prevention and clinical management strategies.
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