ORIGINAL ARTICLE   

Giornale Italiano di Dermatologia e Venereologia 2020 February;155(1):41-5

DOI: 10.23736/S0392-0488.17.05685-1

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Prognostic factors in head and neck melanoma according to facial aesthetic units

Giovanni PAOLINO ¹, Michele CARDONE ¹, Dario DIDONA ² ✉, Elisa MOLITERNI ¹, Luigi LOSCO ³, Paola CORSETTI ¹, Giusy SCHIPANI ⁴, Teresa LOPEZ ¹, Stefano CALVIERI ¹, Ugo BOTTONI ⁴

¹ Dermatological Clinic, Sapienza University, Rome, Italy; ² First Division of Dermatology, Istituto Dermopatico dell’Immacolata, IRCCS, Rome, Italy; ³ Department of Plastic, Reconstructive and Aesthetic Surgery, Sapienza University, Rome, Italy; ⁴ Department of Dermatology, Magna Graecia University, Catanzaro, Italy

BACKGROUND: Head and neck melanoma is a clinical challenge. Indeed, cutaneous head and neck melanoma shows a worse prognosis in comparison to melanomas of other body sites. Although the emphasis on facial cosmetic preservation plays a pivotal role in comparison to other body areas, specific Facial Aesthetic Units (FAU) could also play a key role in the prognostic evaluation of the malignancy.
METHODS: The aim of the current study was to evaluate the general outcome and clinicopathological features of head and neck melanoma and to detect prognostic differences according to each FAU. The Kaplan-Meier product was used to calculate survival curves, while Cox proportional-hazard regression was performed to evaluate the predictive value of each FAU.
RESULTS: A total of 221 head and neck melanoma patients was included in our analysis. In the nasal FAU, we found a high rate of local recurrence, which affected significantly disease-free survival. The worse prognosis was observed in melanoma of the scalp, which showed a greater tendency to skip metastases in internal organs. Moreover, we found that scalp showed a low incidence of non-melanoma skin cancers, if compared to other FAU, highlighting that the scalp local milieu might play a more prominent role in melanoma biology than chronic UV exposition.
CONCLUSIONS: Although FAUs have an aesthetic function, they could also play a role in the evaluation and follow-up of melanoma.

KEY WORDS: Facial neoplasms; Surgery; Melanoma; Prognosis; Retrospective studies