Researchers at the University of North Carolina (UNC), Chapel Hill, have recently published the result of a study conducted there that reveals a death rate in cancer patients with melanomas of the head and neck that is nearly twice as high as patients with melanomas elsewhere. The research team analyzed data from 51,704 US melanoma cases to determine if the location where skin cancer first appears affects the chance of survival. The UNC study indicates a death rate 1.84 times higher when melanomas first appear on the scalp or the neck than when they appear on other parts of the body, including the face and the ears. All cases under review for the study were limited to white, non-Hispanic adults diagnosed with melanoma from 1992 to 2003.

Melanomas originating on the scalp or the neck account for only about 6% of all cases of melanoma but they lead to 10% of the deaths in melanoma patients. Nancy Thomas, MD, PhD, senior author for the study and associate professor of dermatology at UNC’s School of Medicine, offers the recommendation that physicians spend more time examining the scalp when doing full-body cancer exams.

Thomas also says the research team suspects something about scalp and neck melanomas may be different molecularly than melanomas that affect the extremities and other parts of the body. She cites this study as directive for research into tumor cell types associated with different areas of the body.

The study revealed that patients with scalp and neck melanomas were generally older (age 59 versus 55) than patients with other melanomas, more likely male than female (74% versus 54%), and the tumors were thicker than those on other parts of the body (0.8 millimeters versus 0.6 millimeters). The scalp and neck tumors were more likely to be ulcerated than those in other areas and the lymph nodes were more likely to be involved.

Patients with melanomas on the face, ears, or extremities have the best prognosis for long-term survival. The five-year survival rate for these melanomas is 92% but only 83 percent when the melanomas originate on the scalp or neck. The ten-year survival rate proved to be 89% for melanomas on the face, ears, or extremities and 76% for melanomas of the scalp and neck.

The April issue of Archives of Dermatology carries full details of the UNC study. The National Cancer Institute and a Holderness Medical Foundation Fellowship grant funded the study.

Source: University of North Carolina at Chapel Hill