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Evolving treatment strategies in thin cutaneous head and neck melanoma: 1 institution's experience
Author(s) -
Jaber James J.,
Clark Joseph I.,
Muzaffar Kamil,
Ruggiero Francis P.,
Feustel Paul J.,
Frett Michael J.,
Zender Chad A.
Publication year - 2011
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/hed.21403
Subject(s) - medicine , biopsy , sentinel lymph node , melanoma , head and neck , breslow thickness , head and neck cancer , incidence (geometry) , sentinel node , population , dermatology , surgery , cancer , radiology , radiation therapy , breast cancer , physics , cancer research , optics , environmental health
Background Although existing melanoma literature provides recommendations for thinner lesions (≤1 mm) within a heterogeneous population, a focus on the head and neck group is less pervasive. Methods The records of 49 node‐negative individuals with thin head and neck melanoma that underwent surgical intervention ± sentinel lymph node (SLN) biopsy were reviewed. Results A significant increased Breslow thickness and mitotic rate, and a trend toward significance in Clark level ≥ IV were shown in patients that underwent an SLN biopsy versus those that did not. The total number of positive biopsies was 2 (5%). In our subset analysis using the modified American Joint Committee on Cancer recommendations by Wong and colleagues, the incidence of positive SLN biopsy would have increased to 11%. Conclusion We advocate performing an SLN biopsy in thin head and neck melanomas for primary tumors > 0.75 mm, regardless of “high‐risk” features as described by Wong and colleagues. © 2010 Wiley Periodicals, Inc. Head Neck, 2011