title: Evolving treatment strategies in thin cutaneous head and neck melanoma: 1 institution's experience.
abstract: BACKGROUND
  Although existing melanoma literature provides recommendations for thinner lesions (≤1 mm) within a heterogeneous population, a focus on the head and neck group is less pervasive.
  
  
  METHODS
  The records of 49 node-negative individuals with thin head and neck melanoma that underwent surgical intervention ± sentinel lymph node (SLN) biopsy were reviewed.
  
  
  RESULTS
  A significant increased Breslow thickness and mitotic rate, and a trend toward significance in Clark level ≥ IV were shown in patients that underwent an SLN biopsy versus those that did not. The total number of positive biopsies was 2 (5%). In our subset analysis using the modified American Joint Committee on Cancer recommendations by Wong and colleagues, the incidence of positive SLN biopsy would have increased to 11%.
  
  
  CONCLUSIONS
  We advocate performing an SLN biopsy in thin head and neck melanomas for primary tumors > 0.75 mm, regardless of "high-risk" features as described by Wong and colleagues.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Jaber
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Clark
authors.forename: Kamil
authors.initials: K
authors.lastname: Muzaffar
authors.forename: Francis P
authors.initials: FP
authors.lastname: Ruggiero
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Feustel
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Frett
authors.forename: Chad A
authors.initials: CA
authors.lastname: Zender
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D015580:Mohs Surgery / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011300:Preoperative Care; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data*; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome