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Treatment outcome for 424 primary cases of clinical stage I cutaneous malignant melanoma of the head and neck
Author(s) -
Kane William J.,
Yugueros Patricia,
Clay Ricky P.,
Woods John E.
Publication year - 1997
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199709)19:6<457::aid-hed1>3.0.co;2-y
Subject(s) - medicine , occult , stage (stratigraphy) , melanoma , lymph node , neck dissection , surgery , disease , primary tumor , proportional hazards model , head and neck cancer , head and neck , oncology , cancer , metastasis , pathology , paleontology , alternative medicine , cancer research , biology
Background Cutaneous malignant melanoma (CMM) is increasing in frequency. Surgery remains the primary and only curative treatment method. Our aim was to define prognostic factors and outcome predictors for patients with clinical stage I CMM of the head and neck. Methods Surgical treatment and outcome was analyzed for 424 patients with clinical stage I melanoma of the head and neck, completing initial treatment at the Mayo Clinic (1970–1990). The data were analyzed using the Kaplan‐Meier product‐limit method and Cox multiple‐regression models. Results Overall, 180 (42%) patients underwent elective lymph node dissection (ELND) as part of the initial treatment; occult disease was demonstrated in 15 (8.3%). Among patients with tumor > 1.5 mm thick, occult regional disease was found in 15%. Failure of initial treatment occurred in 152 (36%). Overall, 82% and 75% of patients survived 5 and 10 years, respectively. Conclusions Tumor thickness, extent of invasion, and the presence of occult regional metastatic disease were the only independently predictive value ( p < .005) of recurrence. The detection of disease by ELND did not appear to protect the patient from disease progression but identified those with regionally advanced disease and highest risk for recurrence. The development of recurrence significantly reduced but did not eliminate the potential for extended disease‐free survival with subsequent treatment. © 1997 John Wiley & Sons, Inc. Head Neck 19:457–465, 1997.