title: The role of full-thickness scalp resection for management of primary scalp melanoma.
abstract: BACKGROUND
  Scalp melanoma is aggressive and has a proclivity for regional metastasis. We hypothesize that subperiosteal scalp melanoma resection reduces in-transit/satellite recurrence, when compared with subgaleal resection.
  
  
  METHODS
  We identified patients with intermediate to deep, primary scalp melanoma referred to head/neck surgery over an 8-year period. Patients were compared based on scalp resection depth, including subperiosteal (resection to the level of calvarium) and subgaleal (resection including skin, subcutaneous tissue, and galea). The dependent variables were in-transit/satellite recurrence and time to in-transit/satellite recurrence.
  
  
  RESULTS
  Among 48 identified patients, the in-transit/satellite recurrence rate was 16.7%. Subgaleal resection patients had higher in-transit/satellite recurrence rates than subperiosteal resection patients (24.0% vs. 8.7%, P=0.155). Among node-negative patients, subgaleal resection had significantly higher in-transit/satellite metastasis rates when compared with subperiosteal resection (26.3% vs. 0%, P=0.047).
  
  
  CONCLUSIONS
  For node-negative, primary scalp melanoma, subperiosteal resection significantly decreases in-transit/satellite recurrence when compared with subgaleal resection. Given our small sample size, further studies are necessary to confirm these results.
authors: Section of Plastic Surgery, Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan 48105, USA.
authors: Christopher J
authors: CJ
authors: Pannucci
authors: Ryan M
authors: RM
authors: Collar
authors: Timothy M
authors: TM
authors: Johnson
authors: Carol R
authors: CR
authors: Bradford
authors: Riley S
authors: RS
authors: Rees
mesh_terms: D000368:Aged; D002809:Chondroitin Sulfates; D003094:Collagen; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D010521:Periosteum / Q000601:surgery*; D012042:Registries; D012189:Retrospective Studies; D012535:Scalp / Q000473:pathology / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen