Rubatto Marco, Picciotto Franco, Moirano Giovenale, Fruttero Enrico, Caliendo Virginia, Borriello Silvia, Sciamarrelli Nadia, Fava Paolo, Senetta Rebecca, Lesca Adriana, Sapino Anna, Deandreis Désirée, Ribero Simone, Quaglino Pietro
Section of Dermatology, Department of Medical Sciences, University of Turin, Via Cherasco 23, 10121 Turin, Italy.
Dermatologic Surgery Section, Department of Surgery, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza, 10126 Turin, Italy.
J Clin Med. 2023 Jan 10;12(2):553. doi: 10.3390/jcm12020553.
Purpose: This study evaluated the characteristics of patients with head and neck (H&N) melanoma who underwent sentinel lymph node biopsy (SNLB) and assessed the clinical course of patients categorizing subjects according to SLNB status and melanoma location (scalp area vs. non-scalp areas). Methods: Patients undergoing SLNB for melanoma of H&N from 2015 to 2021 were prospectively characterized according to sentinel lymph node (SLN) status. SPECT/CT had been previously performed. Patients were followed until the first adverse event to evaluate progression-free survival. Results: 93 patients were enrolled. SLNB was negative in 75 patients. The median Breslow index was higher for patients with positive SLNB compared with patients with negative SLNB. In addition, the Breslow index was higher for melanoma of the scalp compared with non-scalp melanoma. The median follow-up was 24.8 months. Progression occurred at the systemic level in the 62.5% of cases. There was a significant association between positive SLNB and progression (p-value < 0.01) of disease, with lower progression-free survival for patients with melanoma of the scalp compared with those with melanoma at other anatomic sites (p-value: 0.15). Conclusions: Scalp melanomas are more aggressive than other types of H&N melanomas. Sentinel lymph node status is the strongest prognostic criterion for recurrence.
本研究评估了接受前哨淋巴结活检（SNLB）的头颈部（H&N）黑色素瘤患者的特征，并根据前哨淋巴结活检状态和黑色素瘤位置（头皮区域与非头皮区域）对患者进行分类，评估其临床病程。方法：对2015年至2021年因H&N黑色素瘤接受SNLB的患者，根据前哨淋巴结（SLN）状态进行前瞻性特征分析。此前已进行SPECT/CT检查。对患者进行随访，直至出现首个不良事件，以评估无进展生存期。结果：共纳入93例患者。75例患者的SLNB结果为阴性。与SLNB阴性的患者相比，SLNB阳性的患者的中位Breslow指数更高。此外，头皮黑色素瘤的Breslow指数高于非头皮黑色素瘤。中位随访时间为24.8个月。62.5%的病例在全身水平出现进展。SLNB阳性与疾病进展之间存在显著关联（p值<0.01），与其他解剖部位黑色素瘤患者相比，头皮黑色素瘤患者的无进展生存期更低（p值：0.15）。结论：头皮黑色素瘤比其他类型的H&N黑色素瘤更具侵袭性。前哨淋巴结状态是复发的最强预后标准。
