title: Invasive melanoma of the face: Management, outcomes, and the role of sentinel lymph node biopsy in 260 patients at a single institution.
abstract: OBJECTIVE
  The face is a common site of melanoma occurrence. The purpose of this study was to examine the management and outcomes of patients with invasive melanoma of the face.
  
  
  METHODS
  Patients with invasive melanoma of the face managed at our institution from 1997 to 2008 were retrospectively reviewed. Details of sentinel lymph node biopsy (SNB), disease recurrence, and deaths were recorded.
  
  
  RESULTS
  Two hundred sixty patients were reviewed (mean age 68, mean tumor thickness 0.87 mm). Of 100 patients eligible for SNB (tumor thickness ≥ 1 mm, Clark level ≥ IV, or ulceration) this was performed in only 29 (29%), and those who underwent SNB were younger than those who did not (mean age 59 vs. 79 years, P < 0.0001). SNB was successful in 28 (97%), and no complications occurred. SNB was positive in 3 (11%). After mean follow-up of 30 months, nodal recurrence occurred in 9 (3.5%) and distant recurrence in 20 (7.7%). There were 60 deaths (overall mortality 23%); attributed to melanoma in only 16 cases (disease specific mortality 6.2%).
  
  
  CONCLUSIONS
  Facial melanoma is associated with low rates of regional recurrence despite underutilization of SNB. Older patients are less likely to undergo SNB. Due to the advanced age of patients with facial melanoma, most deaths occurring are from unrelated causes.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Chambers
authors.forename: Tania
authors.initials: T
authors.lastname: Murynka
authors.forename: John P
authors.initials: JP
authors.lastname: Arlette
authors.forename: J Gregory
authors.initials: JG
authors.lastname: McKinnon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005153:Facial Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult