Melanoma of the Scalp and Neck: A Population-Based Analysis of Survival and Treatment Patterns

Abstract

Introduction: Melanoma is an aggressive skin cancer. Large demographic and clinic-pathologic studies are required to identify variations of tumour behavior. The aim of our study was to offer updated epidemiologic data on the scalp and neck melanoma with an overall survival analysis. Method: The SEER database was searched for all scalp and neck melanoma in adult patients between 2000 and 2019. Demographic and clinic-pathologic variables were described. Their impact on overall survival was assessed with the log-rank test after Kaplan–Meier model. A multivariable cox-regression was conducted to identify predictors of decreased survival. A p-value of <0.005 was considered statistically significant. Results: 20,728 Melanomas of the scalp and neck were identified. Mean age was 62.5 years. Gender ratio was 76.3% males. 79% of the tumours were localized at diagnosis. Increasing age, male gender, tumour ulceration, high mitotic rate or nodular subtype were independent prognostic factors of decreased overall survival. Surgery with less than 1 cm margin is associated with the best overall survival in this cohort. No significant difference in OS was seen between less than 1 cm and 1 to 2 cm margins. Conclusion: Knowledge of negative prognostic factors might help identify subgroups at risk and adapt their oncologic treatment.

A Prognostic Model for Cancer‐Specific Survival Among Patients with Nodular Melanoma in Head and Neck

“…26 Although extensive resection may lead to substantial defects, it still has good therapeutic effects. 27 It is also generally believed that the resection range of melanoma is 1 cm away from the cutting edge. 28 As observed in this study, both wide excision with margins more than 1 cm and Mohs surgery yielded similar significant therapeutic effects, which were aligned with numerous previously published studies.…”

“…Notably, the presence of distant metastasis emerged as the most influential factor affecting prognosis, which is associated with lower survival rates in melanoma 26 . Although extensive resection may lead to substantial defects, it still has good therapeutic effects 27 . It is also generally believed that the resection range of melanoma is 1 cm away from the cutting edge 28 .…”