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Excision margins and sentinel lymph node status as prognostic factors in thick melanoma of the head and neck: A retrospective analysis
Author(s) -
Ruskin Olivia,
Sanelli Alexandra,
Herschtal Alan,
Webb Angela,
Dixon Ben,
Pohl Miklos,
Donahoe Simon,
Spillane John,
Henderson Michael A.,
Gyorki David E.
Publication year - 2016
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.24444
Subject(s) - medicine , sentinel lymph node , melanoma , breslow thickness , head and neck , sentinel node , biopsy , lymph node , retrospective cohort study , lymph , surgery , overall survival , radiology , cancer , pathology , cancer research , breast cancer
ABSTRACT Background Recommended margins for thick cutaneous melanoma (Breslow thickness >4 mm; T4) have decreased over recent decades. Optimal margins and the role of sentinel node biopsy (SNB) in thick head and neck melanoma remain controversial. Methods A single‐center review was conducted of patients treated between 2002 and 2012 assessing the impact of excision margins and sentinel lymph node status on locoregional recurrence and melanoma‐specific survival (MSS). Results One hundred eight patients were identified. Median age was 71.1 years and median Breslow thickness was 6.0 mm. Median follow‐up was 40 months. Locoregional recurrence occurred in 27% and there was no significant reduction in recurrence with margins ≥2 cm ( p = .17). Increasing margins did not improve survival ( p = .58). Fifty‐nine patients (55%) underwent SNB, of which 27% were positive. There was a trend toward longer survival for patients who were sentinel lymph node‐negative ( p = .097). Conclusion Wider margins do not significantly improve locoregional recurrence or MSS. Sentinel lymph node involvement reflects a poor prognosis. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1373–1379, 2016