Recurrent cutaneous melanoma of the head and neck

Abstract

Introduction: Recurrent cutaneous melanoma is generally regarded as having an extremely poor prognosis, particularly when regional lymph nodes are involved. A few reports have documented long-term survival among those patients treated for regionally recurrent melanoma. Methods: This article reviews patients at our institution undergoing complete neck dissection for recurrent head and neck melanoma. Results: Twenty-six patients with locoregionally recurrent cutaneous melanoma of the head and neck underwent complete neck dissection with or without parotidectomy. Seventeen of these procedures were for clinically evident cervical lymphadenopathy, whereas 9 of the neck dissections were done electively. Fourteen of the 17 patients with clinical adenopathy were confirmed to have cervical lymph node metastases. Two of the 9 patients who underwent elective neck dissections had pathologic lymph nodes. At 5 years, 38% of the patients with isolated neck recurrences not also having concurrent primary site recurrence were alive without disease. Conclusions: These results provide further evidence suggesting a benefit in the form of long-term survival or cure for patients receiving aggressive surgical treatment for resectable recurrent head and neck melanoma involving cervical lymphatics in the absence of distant metastases. (Otolaryngol Head Neck Surg 1999;120:391-3.)