title: Sentinel node biopsy in head and neck desmoplastic melanoma: an analysis of 244 cases.
abstract: OBJECTIVE
  Desmoplastic melanoma's low rate of sentinel lymph node (SLN) positivity and predilection for the head and neck region have led some to question the role of sentinel lymph node biopsy (SLNB) in patients with this rare histologic variant. Given desmoplastic melanoma's sarcoma-like histology and aberrant clinical behavior, we hypothesized that SLN status may not be indicative of outcomes in desmoplastic melanoma of the head neck. The objective of this study was to compare melanoma-specific survival among patients with head and neck desmoplastic melanoma based on SLN status.
  
  
  METHODS
  Retrospective analysis of patient data and outcomes using the Surveillance Epidemiology and End Results (SEER) database
  
  
  METHODS
  The SEER database was queried for patients who were diagnosed with desmoplastic melanoma and underwent SLNB. Clinicopathologic data and 5-year disease-specific survival (DSS) were compared among patients with positive and negative SLNs.
  
  
  RESULTS
  We identified 244 patients with desmoplastic melanoma of the head and neck who underwent SLNB. Of these, only nine had positive SLNs (3.69%). Among the SLN-positive patients, five (55.6%) had scalp/neck tumors, three (33.3%) had ulcerated tumors, and tumor thickness ranged from 1.7 to 8.5 mm (mean, 4.8 mm). On univariable and multivariable analysis, SLN positivity did not significantly affect DSS in head and neck desmoplastic melanoma (P=.19 and P=.48, respectively).
  
  
  CONCLUSIONS
  Our findings provide further evidence against routine SLNB in head and neck desmoplastic melanoma by demonstrating a lack of prognostic significance related to the procedure, and by confirming a significantly low rate of SLN positivity as well.
authors.affiliation: College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425-5500, USA.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Smith
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lentsch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies; D018426:SEER Program; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate