Factors Influencing Disease Progression in Patients with Head and Neck Melanoma

Abstract

Background: Histological parameters as well as the status of sentinel lymph node are known to be strong prognostic factors in patients with melanoma.

Patients and methods: In this study, we retrospectively analyzed 1,384 patients who were diagnosed with head and neck melanoma between 1976 and 2010 regarding prognostic factors [tumor thickness, level of invasion, sentinel lymph node (SLN) status, ulceration, histological subtype, localization, and gender], overall survival, and disease-free survival.

Results: Patients who developed metastases had a significantly thicker tumor than patients without metastases. Additionally, a thicker tumor was often associated with a higher level of invasion (Clark level). There was no overall survival benefit in patients who underwent SLN dissection when compared to patients who did not (p=0.07). Compared to SLN-negative patients, patients with SLN involvement had a significantly shorter disease-free period (p<0.001) and shorter overall survival time (p<0.001).

Conclusion: In summary, tumor thickness is the most important prognostic factor. SLN dissection does not affect the overall survival of patients with melanoma. However, a positive SLN is a marker for a worse outcome in these patients.

Keywords: Cancer; lymphadenectomy; neck dissection; prognostic markers; sentinel lymph node dissection; survival; tumor thickness.