title: Cutaneous head and neck melanoma (CHNM): A population-based study of the prognostic impact of tumor location.
abstract: BACKGROUND
  Most studies of cutaneous head and neck melanomas (CHNM) have reported poorer survival in CHNM compared with other sites, especially on the scalp/neck.
  
  
  OBJECTIVE
  We sought to compare patient and tumor characteristics between CHNM and cutaneous trunk and extremity melanomas and between CHNM locations (face/ear vs scalp/neck, anterior vs posterior), and to study prognostic factors in patients with CHNM.
  
  
  METHODS
  We studied all CHNM (n = 1074) from 8120 cases of cutaneous melanomas diagnosed in Norway in 2008 to 2012.
  
  
  RESULTS
  Compared with cutaneous trunk and extremity melanomas, CHNM were more frequently found in men, more often nodular and lentigo maligna cutaneous melanomas, and diagnosed at higher T stage (P ≤ .01). CHNM located on posterior sites were diagnosed at significantly higher T stage, and were significantly more often diagnosed with ulceration and at more advanced stage compared with CHNM located on anterior sites (P < .001). T stage and clinical stage were the only significant prognostic factors for melanoma-specific and overall death in the multivariable analysis (P < .001).
  
  
  CONCLUSIONS
  Low number of cases and the relatively high frequency of missing values are limitations.
  
  
  CONCLUSIONS
  More advanced CHNM were diagnosed on posterior compared with anterior locations, but location was not a significant prognostic factor for cutaneous melanoma-specific or overall death in the multivariable models.
authors.affiliation: Department of Dermatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway. Electronic address: phelsing@ous-hf.no.
authors.forename: Per
authors.initials: P
authors.lastname: Helsing
authors.affiliation: Cancer Registry of Norway, Oslo, Norway.
authors.forename: Trude Eid
authors.initials: TE
authors.lastname: Robsahm
authors.affiliation: Cancer Registry of Norway, Oslo, Norway.
authors.forename: Linda
authors.initials: L
authors.lastname: Vos
authors.affiliation: Department of Dermatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
authors.forename: Syed Mohammad Husain
authors.initials: SM
authors.lastname: Rizvi
authors.affiliation: Center for Cancer Biomarkers, Department of Clinical Medicine, Section for Pathology, University of Bergen, Bergen, Norway; Department of Pathology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Lars Andreas
authors.initials: LA
authors.lastname: Akslen
authors.affiliation: Oslo Center for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
authors.forename: Marit Bragelien
authors.initials: MB
authors.lastname: Veierød
mesh_terms: D000328:Adult; D000368:Aged; D005121:Extremities; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000401:mortality; D008297:Male; D008545:Melanoma / Q000401:mortality*; D008875:Middle Aged; D009367:Neoplasm Staging; D009664:Norway / Q000453:epidemiology; D009928:Organ Specificity; D011379:Prognosis; D012042:Registries; D012878:Skin Neoplasms / Q000382:microbiology*; D060726:Torso; D000096142:Cutaneous Malignant Melanoma
keywords: head and neck melanoma; mortality; population-based; prognostic factors; scalp/neck location; visibility