Outcomes of invasive melanoma of the head and neck treated with Mohs micrographic surgery - A multicenter study

Authors

Brandon T. Beal, St. Louis Dermatology & Cosmetic Surgery, St. Louis Skin Cancer Specialists, Troy, Missouri. Electronic address: Brandon.tyler.beal@gmail.com.
Jeremy Udkoff, Department of Dermatology, University of Pittsburgh Medical Center, Philadelphia, Pennsylvania.
Leora Aizman, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Jeremy Etzkorn, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
John A. Zitelli, University of Pittsburgh Medical Center, Zitelli & Brodland, PC, Pittsburgh, Pennsylvania.
Christopher J. Miller, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Thuzar M. Shin, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Joseph F. Sobanko, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
David G. Brodland, University of Pittsburgh Medical Center, Zitelli & Brodland, PC, Pittsburgh, Pennsylvania.

Document Type

Journal Article

Publication Date

9-1-2023

Journal

Journal of the American Academy of Dermatology

Volume

89

Issue

3

DOI

10.1016/j.jaad.2022.12.038

Keywords

Mohs microscopic surgery; Mohs surgery; head and neck; head and neck invasive melanoma; head and neck melanoma; invasive melanoma; melanoma; melanoma outcomes; multicenter

Abstract

BACKGROUND: There are no randomized controlled trials to guide surgical margins for invasive head and neck (H&N) melanoma using conventional excision. Mohs micrographic surgery (MMS) has shown improved local recurrence rates and survival for invasive H&N melanomas. OBJECTIVE: Determine local recurrence (LR), nodal recurrence, and distant recurrence rates, and disease specific survival for invasive melanoma of the H&N treated with MMS. METHODS: A retrospective multicenter study of 785 cases of invasive H&N melanoma treated with MMS using frozen sections with melanoma antigen recognized by T-cells 1 immunohistochemical staining was performed to evaluate long-term outcomes over 12-years. RESULTS: 785 melanomas (thickness: 0.3 mm-8.5 mm) were treated with MMS. LR, nodal recurrence, and distant recurrence rates were 0.51% (4/785), 1.0% (8/785), and 1.1% (9/785) respectively. For T1, T2, T3, and T4 tumors LR was 0.16% (1/636), 1.18% (1/85), 2.22% (1/45), and 5.26% (1/19), respectively. Five and 10-year disease specific survival were 96.8% (95% CI 95.0% to 98.5%) and 93.4% (95% CI 88.5% to 98.3%). LIMITATIONS: A nonrandomized retrospective study. CONCLUSION: MMS achieves significant improvements in LR compared to a meta-analysis of historical cohorts of patients treated with conventional excision. MMS should be considered an important surgical option for invasive H&N melanoma.

APA Citation

Beal, Brandon T.; Udkoff, Jeremy; Aizman, Leora; Etzkorn, Jeremy; Zitelli, John A.; Miller, Christopher J.; Shin, Thuzar M.; Sobanko, Joseph F.; and Brodland, David G., "Outcomes of invasive melanoma of the head and neck treated with Mohs micrographic surgery - A multicenter study" (2023). GW Authored Works. Paper 3503.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3503

Department

School of Medicine and Health Sciences Student Works