The prognostic importance of scalp location in primary head and neck melanoma

Ozao‐Choy, Junko; Nelson, Daniel W.; Hiles, Jason M.; Stern, Stacey L.; Yoon, Jeong Lim; Sim, Myung Shin; Faries, Mark B.

doi:10.1002/jso.24679

Cited by 32 publications

(54 citation statements)

References 23 publications

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“…Thereby, we found not only that thin melanomas in the head and neck region (scalp excluded) were associated with death, but we were also able to identify the scalp as an even stronger risk factor. Fatal thin melanomas were sixfold as likely to arise on the scalp than nonfatal thin melanomas, thus strengthening earlier suggestions that this anatomical location is an important predictor . Clinically, scalp melanomas may be concealed in hair‐bearing areas.…”

Section: Discussionsupporting

confidence: 71%

Clinicopathological factors associated with death from thin (≤ 1·00 mm) melanoma

et al. 2019

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Summary Background Thin cutaneous melanomas (≤ 1·00 mm) are increasing worldwide, causing around a quarter of all melanoma deaths in the U.S.A. and Australia. Identification of predictive factors for potentially fatal thin melanomas could allow better use of resources for follow‐up. Objectives To identify the clinicopathological factors associated with fatal thin melanomas. Methods This large, nested case–case study extracted data from the population‐based Queensland Cancer Registry, Australia. Our cohort consisted of Queensland residents aged 0–89 years who were diagnosed with a single, locally invasive thin melanoma (≤ 1·00 mm) between 1995 and 2014. Fatal cases (eligible patients who died from melanoma) were individually matched to three nonfatal cases (eligible patients who were not known to have died from melanoma) according to sex, age, year of diagnosis and follow‐up interval. Using conditional logistic regression, we calculated odds ratios (ORs) for melanoma‐specific death, adjusting for all collected clinicopathological variables. Results In the cohort, 27 660 eligible patients were diagnosed with a single, thin melanoma. The final case–case series included 424 fatal cases and 1189 nonfatal cases. Fatal cases were sixfold as likely to arise on the scalp as on the back [OR 6·39, 95% confidence interval (CI) 2·57–15·92] and six times as likely to be of thickness 0·80–1·00 mm as of < 0·30 mm (OR 6·00, 95% CI 3·55–10·17). Conclusions Scalp location is a strong prognostic factor of death from thin melanoma. Further, this study provides support that melanomas with a thickness of 0·80–1·00 mm are the more hazardous thin lesions. Patients with these tumour characteristics require specific attention during follow‐up. What's already known about this topic? Thin invasive melanomas (≤ 1·00 mm) contribute a substantial proportion of melanoma fatalities, owing to the high volume of disease. There is a need to find prognostic factors that will better identify fatal thin melanomas at the time of diagnosis. What does this study add? In this large population‐based study, fatal thin tumours were sixfold as likely to be located on the scalp as on the back. Thin melanomas of 0·80–1·00 mm thickness were six times as likely to be associated with death as tumours < 0·30 mm. Scalp location and increasing thickness are strong predictive factors of fatal thin melanomas, indicating that patients with these tumour characteristics require close follow‐up.

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Section: Discussionsupporting

confidence: 71%

Clinicopathological factors associated with death from thin (≤ 1·00 mm) melanoma

et al. 2019

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“…Both of these factors seem to be the key contributors responsible for the greater primary thickness of scalp melanomas. 3,7,8,20 6 | MORPHOLOGIC CLASSIFICATION OF SCALP MELANOMAS 6. Acral lentiginous melanomas are typically found on the palms, soles and subungual locales of the digits or toes.…”

Section: Thickness Of the Scalp Melanoma Serves As The Prime Prognomentioning

confidence: 99%

“…[1][2][3][4][5][6][7] 2 | SCALP MELANOMAS: MAGNITUDE OF THE PROBLEM Scalp melanomas account for 7% of all melanomas. 8 Certain benchmark publications have reported scalp melanomas either as a combined category of "scalp and neck" melanomas or as a larger group of "head and neck" melanomas. Therefore, from these studies we can comprehend only the relative frequency of scalp melanomas within the head and neck region.…”

Section: Introductionmentioning

confidence: 99%

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A brief synopsis on scalp melanoma

Saaiq

Zalaudek

Rao

et al. 2020

Dermatologic Therapy

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Melanoma constitutes one of the most sinister and troublesome malignancies encountered by humanity. Generally, the diagnosis of advanced melanoma connotes a grave prognosis, prompting a sense of looming threat of death, however, the early‐stage detected disease responds well to robust treatment resulting in reasonable survivorship. Scalp melanomas are even more troublesome, because they typically exhibit more aggressive biologic behavior and are often diagnosed at a late stage. This review tries to comprehensively highlight the various diagnostic, therapeutic, and outcome aspects of scalp melanomas. The literature research includes peer‐reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) till May 2020 and reference lists of respective articles. Only articles published in English language were included.

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“…It is known that melanomas located in different locations may have different behavior. Specifically head and neck melanoma have been shown to have poor survival and truncal melanomas are more likely to have positive sentinel nodes ( 15 , 18 ). This is particularly important to this study as melanomas in these areas are the most likely to have MDB.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Multiple Draining Lymph Node Basins in Melanoma: A Matched-Pair Analysis Based on the John Wayne Cancer Institute Experience

et al. 2017

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BackgroundThe prognostic significance of multiple draining basins is controversial in melanoma because analyses have not adequately controlled for standard prognostic variables. We hypothesized that an analysis based on prognostically matched pairs of patients with multiple versus single drainage basins would clarify any independent role of basin number.Study designWe identified patients in our 40-year prospective database, who underwent preoperative lymphoscintigraphy, intraoperative sentinel node biopsy and wide local excision for cutaneous melanoma. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were compared in patients with multiple versus single drainage basins after matching by age, sex, Breslow depth, primary site, and stage at diagnosis.ResultsWe identified 274 patients with multibasin drainage and 1,413 patients with single draining lymph node basins. Matching yielded 259 pairs (226 trunk, 27 head/neck, 6 extremity). Among matched pairs, multibasin drainage did not affect rates of lymph node metastasis (p = 0.84), OS (p = 0.23), DSS (p = 0.53), overall recurrence (p = 0.65), locoregional recurrence (p = 0.58), or distant recurrence (p = 1.0). Multivariable analysis linked higher T stage, ulceration, older age, and lymph node positivity to decreased DSS (p < 0.01) and DFS (p < 0.001). Number of drainage basins was not significant on univariable or multivariable analysis.ConclusionThis analysis, the first to match for standard prognostic factors, suggests that multiplebasin drainage as identified by lymphoscintigraphy has no independent biological or prognostic significance in primary cutaneous melanoma.

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The prognostic importance of scalp location in primary head and neck melanoma

Cited by 32 publications

References 23 publications

Clinicopathological factors associated with death from thin (≤ 1·00 mm) melanoma

Clinicopathological factors associated with death from thin (≤ 1·00 mm) melanoma

A brief synopsis on scalp melanoma

Prognostic Value of Multiple Draining Lymph Node Basins in Melanoma: A Matched-Pair Analysis Based on the John Wayne Cancer Institute Experience

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