Blog Archive

Αλέξανδρος Γ. Σφακιανάκης

Monday, October 11, 2021

Treatment of Cutaneous Melanoma of the Head and Neck With Wide Local Excision Versus Mohs

xlomafota13 shared this article with you from Inoreader

Objectives

Determine if Mohs micrographic surgery (MMS) is associated with improved overall survival compared to wide local excision (WLE) when treating cutaneous melanoma of the head and neck (CMHN) and to report the proportion of patients treated with MMS versus WLE who also underwent sentinel lymph node biopsy (SLNB).

Methods

Retrospective cohort study of the National Cancer Database (NCDB) analyzing the overall survival of patients diagnosed with T1 to T4 CMHN between 2004 and 2016 who were treated with either WLE or MMS.

Results

On multivariable analysis, treatment with WLE versus MMS was not significantly associated with overall survival (HR, 1.094; 95% CI, 0.997–1.201). On multivariable analysis, lower Charlson-Deyo score (HR, 0.489; 95% CI, 0.427–0.560), negative margins (HR, 0.754; 95% CI, 0.705–0.807), and N0 classification (HR 0.698; 95% CI, 0.668–0.730) were associated with improved overall survival. Seventy-seven percent of patients treated with MMS did not undergo SLNB, while 45% of patients treated with WLE did not undergo SLNB (P < .001).

Conclusions

No difference in overall survival between MMS and WLE when treating CMHN. Patients treated with MMS were significantly less likely to undergo SLNB, suggesting an opportunity for enhancement of multidisciplinary care.

Level of Evidence

4 Laryngoscope, 131:2490–2496, 2021

View on the web

No comments:

Post a Comment