title: Optimal management and challenges in treatment of upper facial melanoma.
abstract: This study's purpose was to evaluate clinical and surgical outcomes in patients with upper facial melanoma. A sentinel lymph node (SLN) biopsy database review identified 43 patients receiving a diagnosis of upper facial melanoma between February 1997 and April 2005 at Mayo Clinic Arizona in Scottsdale. Patients underwent wide local excision (n = 40) or Mohs excision (n = 3) and SLN biopsy. Nine patients (21%) had positive margins requiring reexcision. SLN mapping identified the SLN in 39 patients (91%) and drainage to bilateral lymph node basins in 8 (21%). The SLN was positive for melanoma in 2 patients (5%). Recurrence in 33 patients with more than 1 year of follow-up (local in 5 [15%] and regional in 1 [3%]) was treated with salvage surgery; 1 patient developed metastatic disease. Two patients (5%) died, one of an unknown cause and the other of metastatic melanoma. We concluded that oncologic surgery can result in good local disease control in patients with upper facial melanoma.
authors.affiliation: Division of General Surgery, Mayo Clinic, Scottsdale, AZ 85259, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Berdahl
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gray
authors.forename: William J
authors.initials: WJ
authors.lastname: Casey
authors.forename: John J
authors.initials: JJ
authors.lastname: Woog
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002610:Cheek; D005138:Eyebrows; D005142:Eyelid Neoplasms / Q000601:surgery; D005153:Facial Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D005260:Female; D005546:Forehead; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008545:Melanoma / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D015580:Mohs Surgery; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009669:Nose Neoplasms / Q000601:surgery; D012086:Reoperation; D021701:Sentinel Lymph Node Biopsy