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- Title
Sentinel lymph node status is the most important prognostic factor in patients with melanoma of the scalp.
- Authors
Cappello, Zachary J.; Augenstein, Adam C.; Potts, Kevin L.; McMasters, Kelly M.; Bumpous, Jeffrey M.
- Abstract
Objectives/Hypothesis To compare clinicopathologic and prognostic factors associated with scalp melanomas and nonscalp melanomas of the head and neck (H&N). Study Design Post hoc analysis of the database from a multi-institutional, prospective, randomized study. Methods Clinicopathologic factors were assessed and correlated with survival and recurrence. Univariate and multivariate analysis of prognostic factors affecting disease-free survival and overall survival were performed. Results Of 405 patients with H&N melanomas ≥1.0 mm Breslow thickness, 109 patients had melanoma of the scalp. All were Caucasian (100%), with most being male (79.5%) with a mean age of 49.8 years. The mean Breslow thickness was 2.4 mm; 25% had signs of ulceration. Sentinel lymph node (SLN) positivity was seen in 20.9% of scalp melanoma patients, and was more likely in younger patients (44.7 vs. 50.8 years, P = .04) and in those with a Breslow thickness of 2 to 4 mm ( P = .005). The incidence of locoregional and distant recurrence were similar. Overall survival for scalp melanoma patients was significantly impacted by SLN positivity ( P = .03), whereas Breslow thickness and ulceration status predicted poorer survival in nonscalp melanoma patients ( P = .005, P < .0001, respectively). Conclusions In the Sunbelt Melanoma Trial, SLN status was the strongest predictor of overall survival in scalp melanoma. Tumor thickness and ulceration correlated with poorer overall survival in nonscalp H&N melanoma. The prognostic significance of SLN status in the H&N may vary with the melanoma site. Level of Evidence 2c.
- Subjects
MELANOMA; SENTINEL lymph nodes; PROGNOSTIC tests; HEALTH risk assessment; NEUROENDOCRINE tumors; MULTIVARIATE analysis; PATIENTS
- Publication
Laryngoscope, 2013, Vol 123, Issue 6, p1411
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1002/lary.23793