We were very interested in the article entitled "Localization of Regional Lymph Nodes and Melanomas of the Head and Neck" by Alex and colleagues1 in the ARCHIVES.
The management of regional lymph nodes in clinically staged N0 primary malignant melanomas of the trunk and extremities has certainly undergone an important change with the advent of lymph node mapping technology by facilitating the identification of patients at increased risk to fail local-regional therapy. The ability to do this is particularly important now that systemic adjuvant biologic therapy protocols have demonstrated a survival benefit in patients with positive regional lymph nodes.
While this technique has become established for primary cutaneous melanoma of the extremities and the trunk, there is still insufficient evidence to demonstrate its use for primary melanomas of the skin of the head and neck region. While this article1 provides evidence that points out some of the benefits and the . . . [Full Text of this Article]