Hypothesis: An elective neck dissection is required in the treatment of intermediate-thickness (1-4 mm) cutaneous malignant melanoma of the head and neck (CMMHN).
The role of cervical lymphadenectomy in the treatment of patients with intermediate-thickness CMMHN and with no other clinical evidence of disease has been an area of controversy among surgical oncologists specializing in the head and neck for several decades. A recent increase in the incidence of melanoma and new advances in the evaluation and treatment of this disease mandate a critical reappraisal of the role of neck dissection in managing melanomas that arise from the skin of the head and neck. I review prevailing epidemiological trends in melanoma and developments in surgery, biologic therapy, and radiation therapy for CMMHN and place the arguments for and against elective lymph node dissection (ELND) in the context of these technological advances.
BACKGROUND: INCIDENCE, STAGING, AND PROGNOSIS OF MALIGNANT MELANOMA
The incidence of melanoma has been steadily increasing over . . . [Full Text of this Article]
CERVICAL METASTASES IN CMMHN
Incidence
Options for Treatment of the Clinically Node-Negative Neck
PRO: ELECTIVE LYMPH NODE DISSECTION
CON: ELECTIVE LYMPH NODE DISSECTION
Surgical Morbidity
Role of Sentinel Lymph Node Mapping
Role of Radiation Therapy
BOTTOM LINE
