| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Journal of Cranio-Maxillofacial Surgery | ||||
| Publisher: | CHURCHILL LIVINGSTONE | ||||
| Place of Publication: | EDINBURGH | ||||
| Volume: | 42 | ||||
| Number of Issue or Book Chapter: | 5 | ||||
| Page Range: | e252-e258 | ||||
| Date: | 2014 | ||||
| Institutions: | Medicine > Lehrstuhl für Dermatologie und Venerologie Medicine > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie | ||||
| Identification Number: |
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| Keywords: | PRIMARY CUTANEOUS MELANOMA; AMERICAN JOINT COMMITTEE; MALIGNANT-MELANOMA; EXCISION MARGINS; PROGNOSTIC-FACTORS; DRAINAGE PATTERNS; LONG-TERM; BIOPSY; MM; LOCATION; Melanoma; Head and neck; Prognosis; Resection margin; Neck dissection | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 61340 |
Web of ScienceAbstract
Introduction: Head and neck melanoma compromises a group of aggressive tumours with varying clinical courses. This analysis was performed to find anatomic and clinicopathological parameters predictive for lymph node metastasis and overall survival. Material and methods: Data and outcome of 246 patients with a malignant melanoma in the head and neck region were retrospectively analyzed for ...
Abstract
Introduction: Head and neck melanoma compromises a group of aggressive tumours with varying clinical courses. This analysis was performed to find anatomic and clinicopathological parameters predictive for lymph node metastasis and overall survival. Material and methods: Data and outcome of 246 patients with a malignant melanoma in the head and neck region were retrospectively analyzed for predictive parameters. Results: Lentigo maligna melanoma (n = 115) was the most frequent histology, followed by superficial spreading (n = 63) and nodular melanoma (n = 52). More than half of the melanomas (n = 138) were in the face. Tumours of the face and anterior scalp metastasized to lymph nodes of the neck and parotid gland, whereas tumours of the posterior scalp and neck also metastasized to the nuchal region. Advanced Clark level, presence of tumour ulceration and younger age were the strongest predictors of lymph node metastasis in multivariate regression analysis (p < 0.05), but anatomic site, histological subtype and tumour thickness were also associated with lymph node metastasis. Lymph node metastases, distant metastases, ulceration, nodular subtype and non-facial site of origin were the strongest negative prognostic parameters for disease-specific overall survival (p < 0.05). In contrast, the width of resection margin (< 1 cm vs. 1-2 cm vs. > 2 cm) did not correlate with tumour recurrence and overall survival (p > 0.05). Conclusion: Histological subtype diagnosis, anatomic site of origin as well as the established factors tumour thickness, ulceration and depth of invasion are prognostic indicators of cervical lymph node metastasis and overall survival. A resection margin of at least 1 cm seems sufficient in head and neck melanoma. The status of sentinel lymph node biopsy and neck dissection has to be proven within the next years. (C) 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Metadata last modified: 19 Dec 2024 08:08
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