title: The prognostic impact of the anatomical sites in the 'head and neck melanoma':  scalp versus face and neck.
abstract: Cutaneous melanoma is a malignant neoplasia with several demographic and histopathological prognostic factors. Many studies stress that the head and neck region has a worse prognosis compared with other localizations, but the reasons for this worse prognosis are unclear. Therefore, the aim of our study is to analyse the poor prognosis of head and neck melanoma (HNM) with respect to the other anatomical sites, considering the face and neck (F&N) and the scalp separately. We carried out a retrospective analysis of 757 melanoma patients. In particular, we studied the prognostic impact of different melanoma skin localizations (head and neck, trunk, upper extremities and lower extremities). Afterwards, we divided HNM into two subgroups, F&N and scalp, to evaluate their impact in the HNM prognosis. Data showed a significantly lower 5-year overall survival probability for HNM (78.9 versus 93.1% for other body sites; P=0.05). Moreover, on analysing the two anatomical areas considered among HNM, we observed a 5-year overall survival of 81.8% for F&N and 66.7% for scalp. HNM has different and worse prognostic features with respect to other sites, but this trend is not only because of scalp melanoma but is also determined by F&N melanoma, which we believe to be underestimated until now.
authors.affiliation: Department of Dermatology, University of Florence, Italy. vincenzo.degiorgi@unifi.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: de Giorgi
authors.forename: Susanna
authors.initials: S
authors.lastname: Rossari
authors.forename: Alessia
authors.initials: A
authors.lastname: Gori
authors.forename: Marta
authors.initials: M
authors.lastname: Grazzini
authors.forename: Imma
authors.initials: I
authors.lastname: Savarese
authors.forename: Emanuele
authors.initials: E
authors.lastname: Crocetti
authors.forename: Elisa
authors.initials: E
authors.lastname: Cervadoro
authors.forename: Daniela
authors.initials: D
authors.lastname: Massi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005145:Face / Q000473:pathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009333:Neck / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology*; D016019:Survival Analysis