title: Managing regional metastasis in patients with cutaneous head and neck melanoma - is selective neck dissection appropriate?
abstract: BACKGROUND
  Neck dissection is recommended for patients with head and neck cutaneous melanoma and nodal metastasis. However, there appears to be no clear evidence to guide the extent of nodal resection.
  
  
  METHODS
  Loco-regional recurrence (LR), overall survival (OS) and progression free survival (PFS) was retrospectively compared between patients who had Comprehensive neck dissection (CND) and Selective neck dissection (SND).
  
  
  RESULTS
  There was no difference in LR, OS and PFS between CND (n=18) and SND groups (n=79). Extra capsular extension (ECE), frontal disease and increasing number of involved nodes resulted in worse OS and PFS but had no impact on LR.
  
  
  CONCLUSIONS
  Patients with disease limited to one node without ECE can be effectively treated by SND alone. In patients who have these unfavourable pathological features more extensive nodal resection does not improve outcome if they receive radiotherapy. Extent of neck dissection or adjuvant radiotherapy has no impact on overall survival.
authors: Peter MacCallum Cancer Center, Melbourne, Australia. Electronic address: doctorms77@gmail.com.
authors: Mrinal
authors: M
authors: Supriya
authors: Peter MacCallum Cancer Center, Melbourne, Australia.
authors: Vignesh
authors: V
authors: Narasimhan
authors: Division of Cancer Surgery, Peter MacCallum Cancer Center, Melbourne, Australia.
authors: Michael A
authors: MA
authors: Henderson
authors: Division of Head and Neck Surgery, Peter MacCallum Cancer Center, Melbourne, Australia.
authors: Andrew
authors: A
authors: Sizeland
mesh_terms: D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012878:Skin Neoplasms; D015996:Survival Rate; D016896:Treatment Outcome; D000096142:Cutaneous Malignant Melanoma