Dermatological Clinic, Sapienza University, Rome, Italy.
First Division of Dermatology, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy -
G Ital Dermatol Venereol. 2020 Feb;155(1):41-45. doi: 10.23736/S0392-0488.17.05685-1. Epub 2017 Jul 26.
Head and neck melanoma is a clinical challenge. Indeed, cutaneous head and neck melanoma shows a worse prognosis in comparison to melanomas of other body sites. Although the emphasis on facial cosmetic preservation plays a pivotal role in comparison to other body areas, specific Facial Aesthetic Units (FAU) could also play a key role in the prognostic evaluation of the malignancy.
The aim of the current study was to evaluate the general outcome and clinicopathological features of head and neck melanoma and to detect prognostic differences according to each FAU. The Kaplan-Meier product was used to calculate survival curves, while Cox proportional-hazard regression was performed to evaluate the predictive value of each FAU.
A total of 221 head and neck melanoma patients was included in our analysis. In the nasal FAU, we found a high rate of local recurrence, which affected significantly disease-free survival. The worse prognosis was observed in melanoma of the scalp, which showed a greater tendency to skip metastases in internal organs. Moreover, we found that scalp showed a low incidence of non-melanoma skin cancers, if compared to other FAU, highlighting that the scalp local milieu might play a more prominent role in melanoma biology than chronic UV exposition.
Although FAUs have an aesthetic function, they could also play a role in the evaluation and follow-up of melanoma.
头颈部黑色素瘤是一个临床挑战。事实上，与其他身体部位的黑色素瘤相比，头颈部皮肤黑色素瘤的预后更差。虽然与其他身体区域相比，对面部美容保存的重视起着至关重要的作用，但特定的面部美学单位（FAU）也可能在恶性肿瘤的预后评估中发挥关键作用。
本研究的目的是评估头颈部黑色素瘤的总体结果和临床病理特征，并根据每个 FAU 检测预后差异。使用 Kaplan-Meier 乘积法计算生存曲线，同时进行 Cox 比例风险回归评估每个 FAU 的预测价值。
共纳入 221 例头颈部黑色素瘤患者进行分析。在鼻腔 FAU 中，我们发现局部复发率高，这显著影响了无病生存率。头皮黑色素瘤的预后较差，更倾向于跳过内部器官的转移。此外，我们发现与其他 FAU 相比，头皮的非黑色素瘤皮肤癌发病率较低，这表明头皮局部环境可能在黑色素瘤生物学中比慢性紫外线暴露发挥更重要的作用。
尽管 FAU 具有美学功能，但它们在黑色素瘤的评估和随访中也可能发挥作用。
