Managing regional metastasis in patients with cutaneous head and neck melanoma - is selective neck dissection appropriate?

Abstract

BACKGROUND:

Neck dissection is recommended for patients with head and neck cutaneous melanoma and nodal metastasis. However, there appears to be no clear evidence to guide the extent of nodal resection.

METHODS:

Loco-regional recurrence (LR), overall survival (OS) and progression free survival (PFS) was retrospectively compared between patients who had Comprehensive neck dissection (CND) and Selective neck dissection (SND).

RESULTS:

There was no difference in LR, OS and PFS between CND (n=18) and SND groups (n=79). Extra capsular extension (ECE), frontal disease and increasing number of involved nodes resulted in worse OS and PFS but had no impact on LR.

CONCLUSION:

Patients with disease limited to one node without ECE can be effectively treated by SND alone. In patients who have these unfavourable pathological features more extensive nodal resection does not improve outcome if they receive radiotherapy. Extent of neck dissection or adjuvant radiotherapy has no impact on overall survival.

• Authors: Mrinal Supriya, Vignesh Narasimhan, Michael A Henderson, Andrew Sizeland
• Journal: American journal of otolaryngology (Am J Otolaryngol) 2014 Sep-Oct Vol. 35 Issue 5 Pg. 610-6 ISSN: 1532-818X [Electronic] United States
• PMID: 25080830 (Publication Type: Comparative Study, Journal Article)
• Copyright: Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Topics

• Female
• Head and Neck Neoplasms (pathology, surgery)
• Humans
• Lymph Node Excision
• Lymphatic Metastasis
• Male
• Melanoma (secondary, surgery)
• Middle Aged
• Neck Dissection (methods)
• Neoplasm Recurrence, Local
• Radiotherapy, Adjuvant
• Retrospective Studies
• Skin Neoplasms
• Survival Rate
• Treatment Outcome
• Melanoma, Cutaneous Malignant