Cutaneous head and neck melanoma (CHNM): A population-based study of the prognostic impact of tumor location

J Am Acad Dermatol. 2016 Nov;75(5):975-982.e2. doi: 10.1016/j.jaad.2016.06.048. Epub 2016 Aug 18.

Abstract

Background: Most studies of cutaneous head and neck melanomas (CHNM) have reported poorer survival in CHNM compared with other sites, especially on the scalp/neck.

Objective: We sought to compare patient and tumor characteristics between CHNM and cutaneous trunk and extremity melanomas and between CHNM locations (face/ear vs scalp/neck, anterior vs posterior), and to study prognostic factors in patients with CHNM.

Methods: We studied all CHNM (n = 1074) from 8120 cases of cutaneous melanomas diagnosed in Norway in 2008 to 2012.

Results: Compared with cutaneous trunk and extremity melanomas, CHNM were more frequently found in men, more often nodular and lentigo maligna cutaneous melanomas, and diagnosed at higher T stage (P ≤ .01). CHNM located on posterior sites were diagnosed at significantly higher T stage, and were significantly more often diagnosed with ulceration and at more advanced stage compared with CHNM located on anterior sites (P < .001). T stage and clinical stage were the only significant prognostic factors for melanoma-specific and overall death in the multivariable analysis (P < .001).

Limitations: Low number of cases and the relatively high frequency of missing values are limitations.

Conclusion: More advanced CHNM were diagnosed on posterior compared with anterior locations, but location was not a significant prognostic factor for cutaneous melanoma-specific or overall death in the multivariable models.

Keywords: head and neck melanoma; mortality; population-based; prognostic factors; scalp/neck location; visibility.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Extremities
  • Female
  • Head and Neck Neoplasms / mortality
  • Humans
  • Hutchinson's Melanotic Freckle / mortality
  • Male
  • Melanoma / mortality*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Neoplasm Staging
  • Norway / epidemiology
  • Organ Specificity
  • Prognosis
  • Registries
  • Skin Neoplasms / microbiology*
  • Torso