title: Sentinel Lymph Node Dissection in Head and Neck Melanoma has Prognostic Impact on Disease-Free and Overall Survival.
abstract: BACKGROUND
  Sentinel lymph node biopsy (SLNB) plays an important role in the prognostic classification of melanoma and is now a standard staging procedure. However, due to the complex drainage pattern and the risk of site associated morbidity, the potential survival benefit of SLNB is controversial in head and neck (H&N) melanoma.
  
  
  METHODS
  Patients with primary H&N melanoma with a tumor thickness ≥1.00 mm diagnosed in the Department of Dermatology, University of Tuebingen, Germany between 1991 and 2010 were included in this study. Regarding patterns of metastases, disease-free, and overall-survival, 259 patients with SLNB were compared retrospectively to 218 patients without SLNB.
  
  
  RESULTS
  The detection of micrometastasis in SLN proved to be a significant prognostic factor in H&N patients [hazard ratio (HR) 3.69, p < 0.0001]. A significant improvement of recurrence-free survival (RFS, p = 0.011), regional lymph node metastasis-free survival (LFS, p = 0.007), and distant metastasis-free survival (DMSF, p = 0.015) was observed for patients with SLNB versus non-SLNB. Furthermore, a trend towards better overall survival (OS) was found (p = 0.053) for the SLNB group.
  
  
  CONCLUSIONS
  SLNB improved prognostic outcome in H&N melanoma in terms of disease-free and distant metastases survival, reduced subsequent regional lymph node metastases, and showed a trend towards a better OS.
authors.affiliation: Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany. ulrike.leiter@med.uni-tuebingen.de.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Leiter
authors.affiliation: Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Eigentler
authors.affiliation: Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Häfner
authors.affiliation: Department of Oral and Maxillofacial Surgery, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Krimmel
authors.affiliation: Department of Dermatology, University of Erlangen, Erlangen, Germany.
authors.forename: Ugur
authors.initials: U
authors.lastname: Uslu
authors.affiliation: Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Keim
authors.affiliation: Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Weide
authors.affiliation: Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Breuninger
authors.affiliation: Institute of Clinical Epidemiology and Medical Biostatistics, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Martus
authors.affiliation: Center for Dermato-Oncology, Department of Dermatology, Eberhard-Karls-University of Tuebingen, Tübingen, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Garbe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018572:Disease-Free Survival; D004210:Dissection; D005153:Facial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009333:Neck; D061206:Neoplasm Micrometastasis / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012189:Retrospective Studies; D012535:Scalp; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D055815:Young Adult