A prospective population-based study of cutaneous malignant melanoma of the head and neck

Objectives/Hypothesis: For cutaneous malignant melanoma (CMM) of the head a nd neck, neither prognostic factors in population-based groups, nor outcome with respect to surgical resection margins is clear. Therefore, we analyze d data in a regional registry to align treatment results for CMM of the hea d and neck with prognosis and survival times. Study Design: Patient materia l collected prospectively for an 18-year period in a Swedish cancer registr y underwent statistical analyses to establish the most reliable prognostic factors and the influence of surgical treatment on the survival of patients with CMM of the head and neck. Methods: Data originated from the CMM datab ase of the Stockholm-Gotland area of Sweden. Tumor thickness or invasivenes s (Breslow or Clark's levels), extent of surgical margin, sex, histogenetic type, anatomic site, and ulceration were compared statistically for 469 pa tients. Results: Male patients with head and neck CMM had a 68% 10-year sur vival rate; the 10-year survival rate for female patients was 87%. The corr esponding figures for CMM at other sites were 83% and 90%, respectively. Tu mor thickness (or Clark level of invasion) was the only statistically signi ficant prognostic factor in a multivariate analysis (P < .001). The surgica l resection margin seemed to be of no importance to outcome. Conclusions: L ong-term survival after treatment for CMM of the head and neck is better th an reported in most earlier publications, presumably because our evaluation used population-based materials, an important factor in accurate reporting of this kind. Tumor thickness is the main prognostic factor in estimating outcome.