Cutaneous melanoma of the head and neck.

Seventy patients surgically treated in The Netherlands Cancer Institute between 1969 and 1984 for cutaneous melanoma of the head and neck were reviewed with regard to patient data, tumor site, stage, histological criteria, treatment, disease-control and survival. The objectives of the study were to analyse the results of curative treatment of cutaneous melanoma of the head and neck, the value of prognostic factors and the treatment policy for the N0 and N+ neck. Tumor thickness (Breslow Index) was by far the most important prognostic factor in cutaneous melanoma of the head and neck. Other known important factors like level of invasion, tumor subsite, stage, tumor type and ulceration provided additional information. Elective node dissection is advised in lesions thicker than 1.5 mm since N0-N+ transformation is seen in 37% of these patients. Partial neck dissection which includes removal of the nodes adjacent to the primary provides proper regional control except for primary lesions in the neck that require at least a modified neck dissection.