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EXPERIENCE WITH MALIGNANT MELANOMA OF THE HEAD AND NECK

An increasing number of reports in the literature bear evidence of the possible prognostic importance of several factors in malignant melanoma. Aside from the influence of the site and the presence or absence of nodal metastasis on prognosis, the level of penetration, the diameter, and the thickness of the primary lesion have also been implicated as influencing metastatic spread and survival.1–6 Accordingly, a retrospective study of patients with malignant melanoma involving the head and neck, who were seen at our institution from 1955 through 1969, was undertaken. Data on 127 patients with malignant melanoma who had a minimum 5-year follow-up have been analyzed. A good, though not yet significant, correlation appears to exist between length of survival and the diameter and the thickness of the primary lesion, the level of the tumor invasion, and the type of melanoma. A further analysis of patients with Stage I disease lends support to the use of “prophylactic” node dissection when the primary lesions penetrate to levels 4 or 5, or when they are 1.5 mm or greater in thickness. Our current overall approach to the management of malignant melanoma of the head and neck is outlined.