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Optimal resection margin for head and neck cutaneous melanoma.
Albert Y Han1, Suraj Dhanjani1, Kelly Pettijohn1
1Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.
The Laryngoscope
|November 9, 2018
Summary
For head and neck cutaneous melanoma, a narrow surgical resection margin (1-2 cm) offers similar survival outcomes to a wide margin (>2 cm). This finding suggests wider margins do not improve overall or disease-specific survival in this patient group.
Area of Science:
- Dermatology
- Surgical Oncology
- Epidemiology
Background:
- Cutaneous melanoma of the head and neck presents unique surgical challenges.
- Determining optimal surgical resection margins is crucial for patient outcomes.
Purpose of the Study:
- To compare the survival rates of patients with head and neck cutaneous melanoma treated with narrow (1-2 cm) versus wide (>2 cm) surgical resection margins.
Main Methods:
- Population-based cohort analysis using the Surveillance, Epidemiology, and End Results (SEER) database (2004-2014).
- Inclusion of 3,583 patients with head and neck cutaneous melanoma with known resection margins.
- Outcome measures included overall survival (OS) and disease-specific survival (DSS), analyzed using Kaplan-Meier and Cox regression models.
Main Results:
- No significant difference in 5-year or 10-year OS and DSS was observed between narrow and wide resection margin groups.
- Cox regression analysis, controlling for clinical factors, showed similar OS and DSS for narrow margins compared to wide margins (OS 95% CI: 0.918-1.217; DSS 95% CI: 0.856-1.352).
- Tumors were most commonly located on the scalp and neck.
Conclusions:
- Wider surgical margins (>2 cm) do not provide additional survival benefits for primary head and neck cutaneous melanoma compared to narrower margins (1-2 cm).
- Patient survival is influenced by factors such as age, tumor depth, and histology.
- Further research is warranted to investigate the potential benefits of wider margins in cases of local or recurrent melanoma.
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