Cervical lymph-node metastasis from cutaneous melanoma of the head and neck: a search for prognostic factors.
OBJECTIVE
To identify prognostic factors determining overall survival in patients with surgically treated neck node metastases of cutaneous melanoma.


METHODS
A retrospective study was carried out in 70 patients who were surgically treated with curative intent for cervical lymph-node metastasis from cutaneous head and neck melanoma at our institution between 1960 and 1986.


RESULTS
Median follow-up of the 14 patients still alive was 10 years. Of the 70 patients, 64 underwent a radical neck dissection, four a modified radical neck dissection and two a postero-lateral neck dissection. In 63 patients, the node dissection was for palpable involved nodes and in seven for microscopic disease. Survivals after 5 and 10 years were 23% (SE 5%) and 20% (SE 5%), respectively. Five-year survival was 62% (SE 17%) for patients with a melanoma less than 1.5 mm thick and 16% for lesions thicker than 1.5 mm. A regional recurrence in the neck occurred in 16 (23%) patients, of whom 14 were found also to have distant metastases. All patients with regional recurrence died from disease.


CONCLUSIONS
Of the 15 patient-, tumour- and treatment-related factors tested, only the Breslow thickness of the primary lesion carried prognostic significance for survival (Bonferroni corrected P-value: 0.026).
Jonk
A
A
Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Strobbe
L J
LJ
Kroon
B B
BB
Mooi
W J
WJ
Hart
A A
AA
Nieweg
O E
OE
Balm
A J
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D016019:Survival Analysis; D016896:Treatment Outcome