Does morphology have real impact on local and distant recurrences in head and neck cutaneous melanoma?

Introduction. The term “local recurrence” is usually understood as regrowth of a tumor after surgical treatment. The regrowth appears within 3–5 cm from postoperative cicatrix. The causes for such prolonged tumor growth or recurrence of patients with cutaneous melanoma are nonradical surgical treatment as well as satellite or transit metastases that were not removed in-block with primary tumor. A great number of clinical researches, aimed at examination of melanoma, its patterns, anatomical criteria and features of clinical course, gave an opportunity to separate satellite or transit metastases into an independent group. Such metastases are realized inside or subdermally, up to 2 cm or more than 2 cm from the primary tumor, yet, not reaching the location of the first regional barrier.The aim of the study is to define influence of the main prognostic factors such as tumor thickness according to Breslow, the level of invasion according to Clark and the presence of ulceration on the frequency of local recurrence with cutaneous melanoma of head and neck.Materials and methods. The research involved 174 patients with cutaneous melanoma of head and neck (1995–2014). According to our index of contraction of a skin flap (median 30 %) the true borders of resection were clearly defined within all the patients. Thereby, 3 groups were identified with the following resection margin: 1.0 cm, where followed-up treatment results were analyzed.Results. Progression-free survival didn’t correlate with the size of surgical resection margins. The survival rates were the best with the lowest resection margin under 0.5 cm (77.3 %) and the worst with the highest resection margin more then 1.0 cm (38.7 %). That means that the treatment results don’t depend on the width increase of tumor resection margin.Conclusions. We consider that clear surgical margins for any thickness of cutaneous melanoma of head and neck should be as follows: 4 mm – 0.72 mm (p = 0.016). In our work, the influence of the main prognostic factors, such as tumor thickness according to Breslow, level of invasion according to Clark and ulceration on the frequency of head and neck cutaneous melanoma local recurrences had no impact.

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The chemotherapy and radiation in low-grade myofibroblastic sarcoma: is there a role?

10.21203/rs.2.23274/v1 ◽

2020 ◽

Author(s):

Yao Xu ◽

Guijun Xu ◽

Xin Wang ◽

Min Mao ◽

Haixiao Wu ◽

...

Keyword(s):

Prognostic Factors ◽

Surgical Treatment ◽

Head And Neck ◽

Radiation Treatment ◽

Treatment Strategies ◽

Neck Region ◽

Low Grade ◽

Myofibroblastic Sarcoma ◽

Kaplan Meier ◽

Cox Proportional Hazard Regression

Abstract Background: Low-grade myofibroblastic sarcoma (LGMS) is a rare entity with a predilection in the head and neck. There are still no optimal treatment strategies for LGMS. We aimed to investigate the role of chemotherapy and radiation treatment for LGMS. Survival estimate was performed and prognostic factors were identified.Methods: Based on the Surveillance, Epidemiology, and End Result (SEER) database, LGMS patients diagnosed between 2001 and 2015 were involved in our study. Kaplan-Meier curves and log-rank tests were used to estimate overall survival. Cox proportional hazard regression model was performed to identify prognostic factors.Results: A total of 96 eligible patients with LGMS were included, among which 86 (89.6%) received surgical treatment. Twenty-eight (29.2%) patients received radiation treatment while chemotherapy was offered to 20 (10.4%) patients. The median age was 55.0 years old with 22 cases occurred in head and neck region. The mean OS was 125.2 (95%CI 106.3-144.2) months while 1-, 3-, 5- and 10-year OS rates were 88%, 77%, 70% and 59%, respectively. Age older than 60 years, positive nodal status and no surgical treatment were independent prognostic factors for patients with LGMS. Chemotherapy and radiation were not independent prognostic factors for LGMS.Conclusions: Several prognostic factors for LGMS were revealed in this study. Surgical resection is the main therapy while chemotherapy and radiation showed limited effects on survival improvement. Thus, chemotherapy and/or radiation should not be routinely performed in LGMS.

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Trends in Invasive Cutaneous Melanoma in Saskatchewan 1970–1999

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347540300700601 ◽

2003 ◽

Vol 7 (6) ◽

pp. 433-442 ◽

Cited By ~ 9

Author(s):

Marcie J. Ulmer ◽

Jon M. Tonita ◽

Peter R. Hull

Keyword(s):

Prognostic Factors ◽

Cutaneous Melanoma ◽

Excess Mortality ◽

Tumor Thickness ◽

Tumor Characteristics ◽

Anatomic Site ◽

Clark Level ◽

Melanoma Incidence ◽

Number Of Patients ◽

And Gender

Background: Melanoma incidence rates have increased dramatically in white populations worldwide during the past several decades. A more modest increase has been observed for melanoma-related mortality. Cause-specific and disease-free survivals are related to tumor characteristics, gender, age, and possibly anatomic site. It is difficult to accurately assess these trends without information on tumor thickness that is often unavailable. Objective: This study determines trends in melanoma incidence, mortality, and survival in Saskatchewan for a 30-year period, incorporating analysis of tumor thickness. Methods: Information about cases of primary cutaneous melanoma for the 30-year period 1970–1999 was obtained from the population-based Saskatchewan Cancer Registry. A 50% random sample of charts was reviewed to collect information about Breslow depth, Clark level, and other demographic data not available from the Registry. Multivariate regression analysis was used to determine the significance of prognostic factors on incidence and five-year relative survival rates. Results: The number of patients registered increased dramatically during the study period. The increase was greatest for thin lesions in all age groups. Anatomic site varied by gender. Head and neck tumors showed continual increase in risk with increasing age. Mortality rates in females have been stable over time but increased for males in the 1990s. The prognostic factors that predicted excess mortality at five years were tumor thickness, Clark level, and gender. Conclusion: The observed increase in melanoma appears to be real and not the result of increased surveillance or screening. Tumor characteristics (Breslow depth, Clark level) and gender were significant prognostic indicators of five-year excess mortality.

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Clinical prognostic factors and outcomes for the surgical treatment of recurrent squamous cell carcinoma of the head and neck

Annals of Surgical Oncology ◽

10.1007/bf02524008 ◽

2004 ◽

Vol 11 (S2) ◽

pp. S63-S63

Author(s):

V. M. Bondar ◽

J. D. Ellenhorn ◽

D. Qiah ◽

S. Berndt ◽

L. D. Wagman ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Surgical Treatment ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Recurrent Squamous Cell Carcinoma

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Reirradiation in Head and Neck Recurrent or Second Primary Tumor: Efficacy, Safety, and Prognostic Factors

Tumori Journal ◽

10.5301/tj.5000368 ◽

2015 ◽

Vol 101 (5) ◽

pp. 585-592 ◽

Cited By ~ 13

Author(s):

Michela Buglione ◽

Marta Maddalo ◽

Ercole Mazzeo ◽

Pierluigi Bonomo ◽

Luigi Spiazzi ◽

...

Keyword(s):

Prognostic Factors ◽

Head And Neck ◽

Primary Tumor ◽

Second Primary ◽

Second Primary Tumor

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Problems in the measurement of tumor thickness and level of invasion in cutaneous melanoma

Human Pathology ◽

10.1016/s0046-8177(77)80061-0 ◽

1977 ◽

Vol 8 (1) ◽

pp. 1-2 ◽

Cited By ~ 59

Author(s):

Alexander Breslow

Keyword(s):

Cutaneous Melanoma ◽

Tumor Thickness ◽

Level Of Invasion

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SURGICAL TREATMENT OF HEAD AND NECK CUTANEOUS MELANOMA: A MODERN APPROACH TO THE PROBLEM

Head and neck tumors (HNT) ◽

10.17650/2222-1468-2016-6-4-19-25 ◽

2016 ◽

Vol 6 (4) ◽

pp. 19-25

Author(s):

M. B. Pak ◽

A. M. Mudunov ◽

L. V. Demidov ◽

R. I. Azizyan ◽

V. Zh. Brzhezovskiy ◽

...

Keyword(s):

Surgical Treatment ◽

Head And Neck ◽

Cutaneous Melanoma ◽

Modern Approach

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Considerations for Timing of Defect Reconstruction in Cutaneous Melanoma of the Head and Neck

Facial Plastic Surgery ◽

10.1055/s-0039-1693469 ◽

2019 ◽

Vol 35 (04) ◽

pp. 404-409 ◽

Cited By ~ 2

Author(s):

Arya W. Namin ◽

Georgeanne E. Cornell ◽

Emily H. Smith ◽

Robert P. Zitsch

Keyword(s):

Head And Neck ◽

Local Excision ◽

Cutaneous Melanoma ◽

Wide Local Excision ◽

Tumor Thickness ◽

Margin Status ◽

Lentigo Maligna ◽

Positive Margins ◽

Lentigo Maligna Melanoma ◽

Delayed Reconstruction

AbstractThe objective of this study is to identify the incidence and characteristics of cases with positive margins on wide local excision for cutaneous melanoma of the head and neck (CMHN) and therefore provide a potential basis for selectively delaying reconstruction pending final histological clearance of melanoma. A systematic review of English language articles was performed on studies retrieved from PubMed and Web of Science. Original investigations published between July 1999 and June 2018 reporting on margin status of CMHN wide local excision specimens were included in the review. The incidence of positive margins after definitive resection for cutaneous melanoma in the literature ranges from 6 to 20.9%. The incidence is higher in cases of advanced patient age, diagnosis by shave biopsy, lentigo maligna melanoma subtype, desmoplastic subtype, tumor thickness, and ulceration. Delayed reconstruction remains the most oncologically sound decision, allowing for interpretation of margin status on paraffin-embedded tissue sections. However, resection and the resultant defect closure in a single stage is more expedient and potentially a more efficient use of resources. The risk–benefit ratio of immediate versus delayed reconstruction must be considered for each case. The incidence of positive margins is higher in cases of advanced patient age, diagnosis by shave biopsy, lentigo maligna melanoma subtype, desmoplastic subtype, increasing tumor thickness, and the presence of ulceration; delayed reconstruction should be strongly considered in these cases.

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Primary Malignant Melanoma of Maxilla: Report of a Case with Discussion

Case Reports in Dentistry ◽

10.1155/2014/624306 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4

Author(s):

G. Shirisha Rani ◽

T. Vinay Kumar ◽

Balaram Kolasani ◽

Md Rezwana Begum ◽

Anu Priya Srinivasan

Keyword(s):

Surgical Treatment ◽

Malignant Melanoma ◽

Oral Cavity ◽

Head And Neck ◽

Cutaneous Melanoma ◽

Dental Clinic ◽

Oral Melanoma ◽

Pigmented Lesion ◽

Oral Malignant Melanoma ◽

Rule Out

Primary oral malignant melanoma, very rare neoplasm of melanocytic origin, usually presents as a bluish black to tan-brown colored lesion Which is accounting for 0.2 to 8% of all melanomas, 1.6% of all head and neck malignancies, and 0.5% of all oral neoplasia. In general, the prognosis of oral melanoma is poor and worse than that of cutaneous melanoma. Here a case of oral malignant melanoma is presented, which was undetected during the first visit to a dental clinic. When a simple oral surgical treatment was carried out in that region, it resulted in the appearance of a massive pigmented lesion which was histopathologically diagnosed as malignant melanoma. This paper is presented to reemphasize the fact that any pigmented lesion in the oral cavity should be viewed with suspicion and proper investigation (biopsy) should be carried out to rule out any untoward experiences later.

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