Is head and neck melanoma a distinct entity? A clinical registry-based comparative study in 5702 patients with melanoma

Summary Background The head and neck region is more heavily exposed to ultraviolet (UV) radiation than any other body site. Therefore, cutaneous malignant melanoma (CMM) of the head and neck area is proposed to have notable differences from melanoma at other body sites regarding clinicopathological features and survival of patients. Objectives The present retrospective study based on clinical registry data aims to compare clinical features and prognostic factors of head and neck melanoma (HNM) vs. melanoma at other anatomical regions (MOR) in order to detect differences which may be associated to the mode of sun exposure. Methods The clinical records and histopathological findings of 844 patients with clinical stage I and II invasive HNM were compared with the data of 4858 patients with MOR. Survival analysis was performed using the Kaplan–Meier estimate, and the multivariate Cox proportional hazard model was used to evaluate independent prognostic factors. Results Melanoma density was clearly higher for HNM than for MOR: this was particularly true for the face, where it was elevated by a factor of 2·6. There was a higher male/female ratio in patients with HNM and they were significantly older than patients with MOR (P