Breanne E Terakedis1, Christopher J Anker2, Sancy A Leachman3, Robert H I Andtbacka4, Glen M Bowen5, William T Sause6, Kenneth F Grossmann7, Tawnya L Bowles8, R Dirk Noyes8, Ying J Hitchcock1, Kenneth M Boucher9, Dennis C Shrieve1. 1. Department of Radiation Oncology, University of Utah, Salt Lake City, Utah. 2. Department of Radiation Oncology, University of Utah, Salt Lake City, Utah. Electronic address: chris.anker@hci.utah.edu. 3. Department of Dermatology, Oregon Health Sciences University, Center for Health and Healing, Portland, Oregon. 4. Department of Surgery, University of Utah, Salt Lake City, Utah. 5. Department of Dermatology, University of Utah, Salt Lake City, Utah. 6. Department of Radiation Oncology, Intermountain Medical Center, Murray, Utah. 7. Department of Medicine, University of Utah, Salt Lake City, Utah. 8. Department of Surgery, Intermountain Medical Center, Murray, Utah. 9. Department of Oncological Sciences, University of Utah, Salt Lake City, Utah.
Abstract
BACKGROUND: Patients with melanoma of the scalp may have higher failure (recurrence) rates than melanoma of other body sites. OBJECTIVE: We sought to characterize survival and patterns of failure for patients with scalp melanoma. METHODS: Between 1998 and 2010, 250 nonmetastatic patients underwent wide local excision of a primary scalp melanoma. Kaplan-Meier analyses were performed to evaluate overall survival, scalp control, regional neck control, distant metastases-free survival, and disease-free survival. RESULTS: Five-year overall survival was 86%, 57%, and 45% for stages I, II, and III, respectively, and 5-year scalp control rates were 92%, 75%, and 63%, respectively. Five-year distant metastases-free survival for these stages were 92%, 65%, and 45%, respectively. Of the 74 patients who recurred, the site of first recurrence included distant disease in 47%, although 31% recurred in the scalp alone. LIMITATIONS: This is a retrospective review. CONCLUSION: Distant metastases-free survival and overall survival for stage II and III patients with scalp melanoma are poor, and stage III patients experience relatively high rates of scalp failure suggesting that these patients may benefit from additional adjuvant systemic and local therapy. Further research is needed to characterize the environmental, microenvironmental, and genetic causes of the increased aggressiveness of scalp melanoma and to identify more effective treatment and surveillance methods.
BACKGROUND:Patients with melanoma of the scalp may have higher failure (recurrence) rates than melanoma of other body sites. OBJECTIVE: We sought to characterize survival and patterns of failure for patients with scalp melanoma. METHODS: Between 1998 and 2010, 250 nonmetastatic patients underwent wide local excision of a primary scalp melanoma. Kaplan-Meier analyses were performed to evaluate overall survival, scalp control, regional neck control, distant metastases-free survival, and disease-free survival. RESULTS: Five-year overall survival was 86%, 57%, and 45% for stages I, II, and III, respectively, and 5-year scalp control rates were 92%, 75%, and 63%, respectively. Five-year distant metastases-free survival for these stages were 92%, 65%, and 45%, respectively. Of the 74 patients who recurred, the site of first recurrence included distant disease in 47%, although 31% recurred in the scalp alone. LIMITATIONS: This is a retrospective review. CONCLUSION: Distant metastases-free survival and overall survival for stage II and III patients with scalp melanoma are poor, and stage III patients experience relatively high rates of scalp failure suggesting that these patients may benefit from additional adjuvant systemic and local therapy. Further research is needed to characterize the environmental, microenvironmental, and genetic causes of the increased aggressiveness of scalp melanoma and to identify more effective treatment and surveillance methods.
Authors: Kirsten M Baecher; Michael K Turgeon; Caroline R Medin; Geetha Mahendran; Terrill M Flakes; Keith A Delman; Michael C Lowe Journal: Am Surg Date: 2021-11-11 Impact factor: 0.688
Authors: Renee P Wood; Jane S Heyworth; Nina S McCarthy; Audrey Mauguen; Marianne Berwick; Nancy E Thomas; Michael J Millward; Hoda Anton-Culver; Anne E Cust; Terence Dwyer; Richard P Gallagher; Stephen B Gruber; Peter A Kanetsky; Irene Orlow; Stefano Rosso; Eric K Moses; Colin B Begg; Sarah V Ward Journal: Cancer Epidemiol Biomarkers Prev Date: 2020-08-20 Impact factor: 4.254