Related Experiment Video
Updated: Jan 26, 2026
Analysis of Lymph Node Volume by Ultra-High-Frequency Ultrasound Imaging in the Braf/Pten Genetically Engineered Mouse Model of Melanoma
Published on: September 8, 2021
Clinically node-negative head and neck mucosal melanoma: An analysis of current treatment guidelines & outcomes
Sina J Torabi1, Liliya Benchetrit1, Todd Spock1
1Department of Surgery (Section of Otolaryngology), Yale University School of Medicine, 800 Howard Ave, 4th Floor, New Haven, CT 0519, United States.
Objectives:
To analyze head and neck mucosal melanoma (MM) treatment patterns, and their association with survival, relative to National Comprehensive Cancer Network (NCCN) guidelines.
Material & Methods:
Adult head and neck MM patients with clinically-staged T3/4aN0 disease were identified in a retrospective analysis of the National Cancer Database (2010-2014) and stratified into sinonasal cavity (SN) and oral cavity, oropharynx, larynx, or hypopharynx (non-SN) cohorts.
Results:
We identified 353 SN and 79 non-SN MM cases. The majority of patients were treated with surgery (SN: 92.4%; non-SN 84.8%), within NCCN guidelines. Treatment within the non-SN MM NCCN recommendation of elective neck dissection (END) was approximately 26.6%. END is not recommended for SN MM and was not performed in 91.5% of cases. Radiotherapy (RT) is recommended in both SN and non-SN MM and was utilized in 63.5% of SN patients and 46.8% of non-SN patients. END was not independently associated with OS compared to surgery alone (SN HR: 1.350 [95% CI: 0.733-2.485]; non-SN HR: 3.460 [95% CI: 0.912-13.125]). RT was independently associated with improved OS in SN MM cases (HR: 0.679 [95% CI: 0.479-0.963]), but not in non-SN MM cases (HR: 0.824 [95% CI: 0.331-2.051]).
Conclusion:
The majority of patients with head and neck MM are not treated within NCCN guidelines. The use of recommended END in non-SN patients is low. Similarly, adjuvant RT utilization is low. Our analysis shows that while greater use of RT may increase survival rates in this disease, the utility of END is unclear.
Related Concept Videos
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:26Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...
01:19Veins of Head and Neck
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
01:14Node Analysis for AC Circuits
To unravel the complexities of this system, nodal analysis is employed, a powerful technique founded on Kirchhoff's current law (KCL), which remains valid for phasors. AC circuits can effectively be...
01:10Mesh Analysis with Current Sources
Current Source in One Mesh: The analysis process is straightforward when a current source is found in only one mesh within the circuit. Mesh currents are assigned as usual, with the mesh containing the current source excluded from the analysis. Kirchhoff's voltage law...
01:25Mucosal Barrier of the Stomach
Within parietal cells, carbonic acid is first formed through the reaction of water and carbon dioxide. The dissociation of carbonic acid releases bicarbonate and hydrogen ions. The bicarbonate...