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Postbiopsy Pigmentation is Prognostic in Head and Neck Melanoma

  • Melanoma
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Abstract

Purpose

To assess postbiopsy pigmentation (PBP) as a prognostic feature in patients with cutaneous head and neck (H&N) melanoma.

Methods

Retrospective review of patients undergoing sentinel lymph node biopsy (SLNB) for H&N melanoma (1998–2018). PBP was defined as visible remaining pigment at the scar or biopsy site that was documented on physical exam by both a medical oncologist and a surgeon at initial consultation. Variables associated with disease-free survival (DFS) and overall survival (OS) were analyzed using multivariable Cox proportional hazards models.

Results

Among 300 patients, 34.3% (n = 103) had PBP and 44.7% (n = 134) had microscopic residual disease on final pathology after wide local excision. Prognostic factors associated with DFS included advanced age, tumor depth, ulceration, PBP, and positive SLNB (p < 0.05). Patients with PBP fared worse than their counterparts without PBP in 5-year DFS [44.1% (31.1–56.3%) vs. 73.0% (64.1–80.0%); p < 0.001] and 5-year OS [65.0% (50.0–76.6%) vs. 83.6% (75.7–89.2%); p = 0.005]. After multivariable adjustment, PBP remained associated with shorter DFS [hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.01–2.93; p = 0.047], but was not prognostic of OS.

Conclusions

In patients with H&N melanoma, PBP is associated with significantly shorter DFS. Patients with PBP may warrant greater consideration for SLNB and closer postoperative surveillance.

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Authors and Affiliations

  1. Department of Surgery, Gastrointestinal Tumor and Endocrine Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Becky B. T. King MD, Brandon C. Chapman MD, Ana Gleisner MD, PhD, Camille Stewart MD, Chloe Friedman MPH, Martin D. McCarter MD & Nicole Kounalakis MD

  2. Department of Radiology, University of Colorado School of Medicine, Aurora, CO, USA

    Jennifer J. Kwak MD

Authors
  1. Becky B. T. King MD
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  2. Brandon C. Chapman MD
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  3. Ana Gleisner MD, PhD
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  4. Camille Stewart MD
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  5. Chloe Friedman MPH
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  6. Jennifer J. Kwak MD
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  7. Martin D. McCarter MD
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  8. Nicole Kounalakis MD
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Correspondence to Nicole Kounalakis MD.

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King, B.B.T., Chapman, B.C., Gleisner, A. et al. Postbiopsy Pigmentation is Prognostic in Head and Neck Melanoma. Ann Surg Oncol 26, 1046–1054 (2019). https://doi.org/10.1245/s10434-019-07185-2

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  • DOI: https://doi.org/10.1245/s10434-019-07185-2

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