Therapeutic lymphadenectomy in melanomas of the head and neck.
This retrospective study describes patients with loco-regionally metastasized melanoma of the head and neck. All patients underwent a therapeutic lymph node dissection. The 3-year survival rate was 35%. Duration of disease-free interval, number of lymph nodes involved, and extent of neck dissection proved of no influence on survival rates. Locoregional recurrence occurred in 10 patients and always proved to be a sign of systemic dissemination. Ultimately, 19 patients developed systemic disease. More than 40% developed cerebral metastases and the cerebrum was the second most involved site. As cerebral involvement occurs often in head and neck melanoma, a computed tomography or magnetic resonance imaging scan of the brain is recommended in the routine work-up before lymph node dissection. Furthermore, because the extent of the surgical procedure had no influence on local recurrence rate and overall survival, a selective approach, preserving functional structures, is advocated.
Van de Vrie
W
W
Dr. Daniël den Hoed Cancer Center, Department of Surgical Oncology, Groene Hilledijk, Rotterdam, The Netherlands.
Eggermont
A M
AM
Van Putten
W L
WL
Wiggers
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012189:Retrospective Studies; D015996:Survival Rate