Advanced Head and Neck Melanomas Often Found Where They’re Hardest to See

Advanced Head and Neck Melanomas Often Found Where They’re Hardest to See

Advanced-stage cutaneous head and neck melanomas are diagnosed more often on the scalp or back of the neck than toward the front of the body, like the face or ears, according to a study published in the Journal of the American Academy of Dermatology.

Cutaneous head and neck melanomas (CHNM) are biologically diverse, and constitute 12% to 27% of all cutaneous, or skin, melanomas. CHNMs are more frequently found in older patients. Studies suggest a worse prognosis from these tumors compared with cutaneous trunk and extremity melanomas (CTEM).

Per Helsing, MD at Department of Dermatology, Oslo University Hospital–Rikshospitalet, and colleagues conducted a population-based study in Norway to compare patient and tumor characteristics between CHNM and cutaneous trunk and extremity melanomas, and between CHNM locations (face/ear versus scalp/neck, anterior versus posterior). Additionally, the researchers explored the prognostic factors in patients with CHNM.

A total of 1,074 patients (53.7% men) diagnosed with first-time invasive cutaneous head and neck melanoma (CHNM) between 2008 and 2012 in Norway were included in the analysis; this comprised 13% of all cutaneous melanomas diagnosed in the country during that time period.

The study, “Cutaneous head and neck melanoma (CHNM): A population-based study of the prognostic impact of tumor location,” revealed that 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 (a staging system describing the size of a primary tumor). Moreover, a higher T stage, ulceration and advanced stage were more frequent in CHNMs located on posterior sites. Among patients with CHNM, 7.1% died of cutaneous melanoma during follow-up.

The researchers also found that T stage and clinical stage were both prognostic factors for melanoma-specific and overall death.

“To our knowledge, this is the first study examining CHNM and prognosis in a nationwide study,” the researchers wrote, according to a news release. “Posterior lesions (scalp and back of neck) were more often diagnosed at a higher T stage, were more often ulcerated, and diagnosed at more advanced clinical stage than CHNM on anterior sites.

“Posterior location of CHNM was a stronger prognostic factor than the scalp/neck location. However, location of CHNM was a not a significant prognostic factor of [cutaneous melanoma]-specific death or overall death in the multivariable analysis, taking other prognostic factors into account.”

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