Evolving treatment strategies in thin cutaneous head and neck melanoma: 1 institution's experience

✍ Scribed by James J. Jaber; Joseph I. Clark; Kamil Muzaffar; Francis P. Ruggiero; Paul J. Feustel; Michael J. Frett; Chad A. Zender

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 98 KB
• Volume: 33
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.21403

✦ Synopsis

Abstract

Background

Although existing melanoma literature provides recommendations for thinner lesions (≤1 mm) within a heterogeneous population, a focus on the head and neck group is less pervasive.

Methods

The records of 49 node‐negative individuals with thin head and neck melanoma that underwent surgical intervention ± sentinel lymph node (SLN) biopsy were reviewed.

Results

A significant increased Breslow thickness and mitotic rate, and a trend toward significance in Clark level ≥ IV were shown in patients that underwent an SLN biopsy versus those that did not. The total number of positive biopsies was 2 (5%). In our subset analysis using the modified American Joint Committee on Cancer recommendations by Wong and colleagues, the incidence of positive SLN biopsy would have increased to 11%.

Conclusion

We advocate performing an SLN biopsy in thin head and neck melanomas for primary tumors > 0.75 mm, regardless of “high‐risk” features as described by Wong and colleagues. © 2010 Wiley Periodicals, Inc. Head Neck, 2011