Palacios-Diaz Rodolfo David, de Unamuno-Bustos Blanca, Pozuelo-Ruiz Mónica, Morales-Tedone Enrico Giorgio, Ballester-Sánchez Rosa, Botella-Estrada Rafael
Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain.
Department of Dermatology, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain.
J Clin Med. 2023 Dec 13;12(24):7643. doi: 10.3390/jcm12247643.
Scalp melanomas (SM) have been previously associated with poor overall and melanoma-specific survival rates. The aim of this study was to describe and compare the clinicopathological characteristics and survival outcomes of SM and non-scalp cutaneous head and neck melanoma (CHNM). An observational multi-center retrospective study was designed based on patients with CHNM followed in two tertiary care hospitals. A hundred and fifty-two patients had CHNM, of which 35 (23%) had SM. In comparison with non-scalp CHNM, SM were more frequently superficial spreading and nodular subtypes, had a thicker Breslow index median (2.1 mm vs. 0.85 mm), and a higher tumor mitotic rate (3 vs. 1 mitosis/mm) ( < 0.05). SM had a higher risk of recurrence and a higher risk of melanoma-specific death ( < 0.05). In the multivariate analysis, scalp location was the only prognostic factor for recurrence, and tumor mitotic rate was the only prognostic factor for melanoma-specific survival. We encourage routinely examining the scalp in all patients, especially those with chronic sun damage.
头皮黑色素瘤（SM）此前一直与总体生存率和黑色素瘤特异性生存率较低相关。本研究的目的是描述和比较头皮黑色素瘤与非头皮皮肤头颈部黑色素瘤（CHNM）的临床病理特征及生存结果。基于两家三级医疗中心随访的CHNM患者开展了一项观察性多中心回顾性研究。152例患者患有CHNM，其中35例（23%）为SM。与非头皮CHNM相比，SM更常见为浅表扩散型和结节型亚型，Breslow指数中位数更高（2.1 mm对0.85 mm），肿瘤有丝分裂率更高（3对1个有丝分裂/毫米）（P<0.05）。SM复发风险更高，黑色素瘤特异性死亡风险更高（P<0.05）。在多变量分析中，头皮部位是复发的唯一预后因素，肿瘤有丝分裂率是黑色素瘤特异性生存的唯一预后因素。我们鼓励对所有患者常规检查头皮，尤其是那些有慢性阳光损伤的患者。
