Clinicians should be aware of higher risk cutaneous head and neck melanoma (CHNM) lesions and their potentially worse prognosis when considering appropriate therapies for their patients. According to recent data, CHNM have poorer outcomes relative to melanoma on alternate anatomical sites.1 And, more specifically, peripherally located CHNM appear to have poorer outcomes than centrally located CHNM, a new study indicates.2
Cutaneous head and neck melanomas have distinct characteristics and have been reported to constitute approximately 12% to 21% of melanomas annually. The primary environmental risk factor for the development of melanoma is sun exposure, particularly intermittent and intense exposures in childhood that lead to blistering sunburns. This may, in part, explain the high incidence of melanoma in the head and neck region.
There are several factors that are thought play a role in the poorer outcomes seen in CHNM. Compared with melanomas that occur on other anatomic locations, this subset of tumors may be thicker at the time of diagnosis and may present at a more advanced stage.
In addition, the optimal tumor resection margins in the head and neck region are oftentimes very challenging to achieve due to anatomic constraints. And, lymphatic drainage of this region is variable and complex.
Although epidemiologic and clinical-histological differences according to sublocations (peripheral vs. central) have been reported in the literature, their impact on survival has not been largely explored.
In a recent retrospective study, José Antonio Avilés-Izquierdo, M.D., and fellow colleagues from the department of dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain, evaluated the epidemiological, clinical, histological and survival characteristics in a cohort of patients with CHNM.