Improved overall survival of melanoma of the head and neck treated with Mohs micrographic surgery versus wide local excision

Jamie Hanson, Addison Demer, Walter Liszewski, Neal Foman, Ian Maher

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Optimal surgical management for melanoma of the head and neck remains controversial. Objective: Assess outcomes for melanomas of the head and neck treated with Mohs micrographic surgery (MMS) versus wide local excision (WLE) from the National Cancer Database. Methods: Head and neck melanoma data from the National Cancer Database from years 2004-2015 were analyzed. Results: In total, 50,397 cases of head and neck melanoma were reviewed; 3510 (7%) were treated with MMS and 46,887 (93%) with WLE. After controlling for potential confounding variables, patients treated with MMS were more likely than patients treated with WLE to survive after 5 years (hazard ratio [HR] 1.181, 95% confidence interval [CI] 1.083-1.288; P <.001). Factors associated with a statistically significant survival disadvantage included male sex (HR 1.287, 95% CI 1.242-1.357; P = 0), tumor ulceration (HR 1.687, 95% CI 1.616-1.760; P = 0), and positive surgical margins (HR 1.395, 95% CI 1.306-1.490; P = 0). Patient survival was inversely proportional to tumor Breslow depth. Limitations: Database study, limited number of MMS treated melanomas. Conclusion: MMS is a valid treatment option for melanoma of the head and neck; National Cancer Database data suggests that MMS might confer a survival benefit over WLE.

Original languageEnglish (US)
Pages (from-to)149-155
Number of pages7
JournalJournal of the American Academy of Dermatology
Volume82
Issue number1
DOIs
StatePublished - Jan 2020

Keywords

  • Mohs micrographic surgery
  • NCDB
  • melanoma

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article

Fingerprint Dive into the research topics of 'Improved overall survival of melanoma of the head and neck treated with Mohs micrographic surgery versus wide local excision'. Together they form a unique fingerprint.

Cite this