Recent developments in head and neck melanoma

Abstract

Purpose of review To provide an overview of recently published articles covering melanoma management of the head and neck region. Recent findings Melanoma management represents a rapidly evolving field. The advent of immunotherapy has led to significant changes in diagnosis, treatment, and surveillance for these patients. Invasive interventions including completion lymph node dissection have been largely replaced with increased surveillance driven by robust data showing no significant difference in overall survival. Studies have explored various treatment regimens that offer improved outcomes with the least adverse events, with a recent trend towards neoadjuvant therapy. Research has also shifted towards better understanding genetics and biomarkers that influence response to these medications. The best means to both identify and monitor these changes is being explored. As our understanding of this complex disease process continues to grow, prognosis in patients suffering with melanoma should continue to improve. Summary The expansion of immunotherapy use in melanoma management has led to significantly improved prognosis in diagnosed patients. Present research is largely focused on better understanding the ideal patient populations, dosing, and surveillance for these therapies. Data from these studies will be crucial in better staging and treating patients with melanoma.

Predictors of Nodal Metastasis in Cutaneous Head and Neck Cancers

“…Risk factors for positive SLN include young age, scalp as the subsite, mitotic activity, ulceration, histology, and parotid involvement. The standard of care for regional management after a positive SLNB recently shifted to nodal basin ultrasound surveillance with adjuvant medical therapy as necessary as opposed to completion neck dissection and parotidectomy [ 63 ]. Future studies should delineate the high-risk patients who might benefit from completion neck dissection after a positive SLNB.…”