Melanoma of the head and neck in Auckland

A series of 154 cases of malignant melanoma of the head and neck has been studied retrospectively, representing a subgroup of 972 cases of all sites seen over a 15-year period. There was no significant difference in the mean level of invasion as defined by Clark between head and neck melanomas and lesions of other sites. The primary lesion was most commonly situated on the face and one third of the tumours arose in Hutchison's melanotic freckles. The 5-year survival rate was 59% and the rate of local recurrence 8%. The mean histologically defined closest margin of dissection was 0.7 cm and only three patients underwent prophylactic lymph node resection. The margin of excision did not influence mortality, but if thick lesions were not excised widely then there was an increase in local recurrence. Our results suggest that a more conservative surgical approach may be feasible in selected patients with melanoma of the head and neck.