Prognostic value and therapeutic implications of nodal involvement in head and neck mucosal melanoma

Background: The prognostic significance of nodal involvement is not well established in head and neck mucosal melanoma (HNMM).

Methods: A retrospective, monocentric study was performed on 96 patients with HNMM treated between 2000 and 2017.

Results: At diagnosis, seventeen patients (17.8%) were cN1, with a higher risk for HNMM arising from the oral cavity (p = 0.01). cN status had no prognostic value in patients with nonmetastatic resectable HNMM. No occult nodal metastasis was observed in the cN0 patients after a nodal dissection (ND). The nodal recurrence rate was similar in the cN1 and the cN0 patients. No isolated nodal recurrences were noted. Among the patients who underwent a ND, no benefit of this procedure was noted.

Conclusions: cN1 status is not a prognostic factor in patients with resectable HNMM. Elective ND should not be systematically performed in cN0 HNMM.