Višnjić Aleksandar, Kovačević Predrag, Veličkov Asen, Stojanović Mariola, Mladenović Stefan
Department of Social Medicine, Faculty of Medicine, University of Niš, Niš, 18000, Serbia.
Institute of Public Health of Niš, Niš, 18000, Serbia.
World J Surg Oncol. 2020 Nov 29;18(1):312. doi: 10.1186/s12957-020-02091-4.
Head and neck melanoma (HNM) is specific from the anatomical and etiopathogenetic aspects. In addition to morphopathological parameters, rich vascularization and lymphatic drainage of the head and neck affect the occurrence of lymphogenic and hematogenous metastases, as well as the metastases on both sides of the neck.
A retrospective cross-sectional study included cutaneous melanoma patients who underwent surgery at a clinical center over a 10-year period. The clinical follow-up was at least 60 months. The Kaplan-Meier method was used for the survival analysis. The predictor effect of certain independent variables on a given dichotomous dependent variable (survival) was measured by the Cox regression analysis.
The analysis of demographic and clinical characteristics of 116 patients with HNM revealed that there was no statistically significant difference in age and gender in the total sample. Thirty-three (28.45%) patients were already in stage III or IV of the disease at the first examination, which affected the overall survival rate. The overall 5-year survival was 30.2%. No statistically significant difference in 5-year survival was found in relation to age and location. The period without melanoma progression decreased progressively in the advanced stage. Forty-nine patients (42%) underwent surgery for lymphogenic metastases in the parotid region and/or neck during the follow-up.
Patients with HNM included in this study frequently presented an advanced stage of the disease at the first examination, which is reflected in a low rate of 5-year survival. Early diagnosis and adequate primary treatment can ensure longer survival.
头颈部黑色素瘤（HNM）在解剖学和病因发病学方面具有特殊性。除形态病理学参数外，头颈部丰富的血管化和淋巴引流会影响淋巴源性和血行性转移的发生，以及颈部双侧的转移。
一项回顾性横断面研究纳入了在一个临床中心接受手术治疗达10年的皮肤黑色素瘤患者。临床随访至少60个月。采用Kaplan-Meier法进行生存分析。通过Cox回归分析测量某些自变量对给定二分因变量（生存）的预测效应。
对116例HNM患者的人口统计学和临床特征分析显示，总样本在年龄和性别上无统计学显著差异。33例（28.45%）患者在首次检查时已处于疾病的III期或IV期，这影响了总体生存率。总体5年生存率为30.2%。在5年生存率方面，未发现与年龄和部位有关的统计学显著差异。在晚期，无黑色素瘤进展的时间逐渐缩短。49例（42%）患者在随访期间因腮腺区和/或颈部的淋巴源性转移接受了手术。
本研究纳入的HNM患者在首次检查时疾病常处于晚期，这反映在5年生存率较低。早期诊断和充分的初始治疗可确保更长的生存期。
