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William Stout R, Gallo N, Torres-Small S, Okose O, Zhao C, Hayes T, Gleysteen J, Wood CB. The Role of Socioeconomic Status in Patients With Cutaneous Melanoma of the Head and Neck. Laryngoscope 2024. [PMID: 39185781 DOI: 10.1002/lary.31730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/12/2024] [Accepted: 08/01/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE To determine the effects of socioeconomic status (SES) on cutaneous melanoma of the head and neck. DATA SOURCE Surveillance Epidemiology and End Results (SEER) Program. REVIEW METHODS We conducted a retrospective analysis of patients diagnosed with cutaneous melanoma of the head and neck from 2006 to 2018, utilizing population-based data including socioeconomic status (SES) assessed by the US-based Yost quintile index. SES quintiles ranged from Group 1 (lowest) to Group 5 (highest). We examined disease severity at diagnosis (stage, Breslow thickness, and spread) and survival outcomes (overall survival, cause-specific survival) to assess the impact of SES. RESULTS A total of 53,967 melanomas of the head and neck were identified (14,146 females; 39,821 males; 51,890 white; 125 black; 317 other). Group 1 patients had a significantly higher percentage of end-stage disease (stage IV) at diagnosis (n = 101; 3.2% vs. n = 280; 1.9%, respectively) (p < .001), increased Breslow thickness (.80 mm vs .60 mm, respectively) (p < .001), and higher percentage of distant disease (n = 152; 3.6% vs. n = 431; 2.1%, respectively) (p < .001). Group 1 patients experienced a higher death rate from melanoma than group 5 patients (n = 585; 14% vs n = 1,753; 8.6%). Survival increased with SES. CONCLUSIONS When evaluating cutaneous melanoma of the head and neck, low SES is related to more severe disease at diagnosis and worse survival outcomes. Addressing the underlying causes of this relationship could lead to more equitable management and survival outcomes. LEVEL OF EVIDENCE III Laryngoscope, 2024.
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Affiliation(s)
- R William Stout
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, U.S.A
| | - Nina Gallo
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
- Department of Otolaryngology-New Orleans, Louisiana State University Health Science Center, New Orleans, Louisiana, United States
| | - Sofia Torres-Small
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, U.S.A
| | - Okenwa Okose
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Chenhao Zhao
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Tristan Hayes
- Department of Otolaryngology-New Orleans, Louisiana State University Health Science Center, New Orleans, Louisiana, United States
| | - John Gleysteen
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - C Burton Wood
- Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
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Ma C, Qin R, Cao Y, Dai Y, Hua M, Wang L, Cao L, Fan L, Li K. Nomogram Predicts Prognostic Factors for Head and Neck Cutaneous Melanoma: A Population-Based Analysis. World Neurosurg 2024; 187:e839-e851. [PMID: 38729520 DOI: 10.1016/j.wneu.2024.04.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND The head and neck cutaneous melanoma (HNCM) accounts for 20% of newly diagnosed melanoma. Research on prognostic models for their survival yet remains largely unexplored. This study employed a nomogram approach to develop and validate a predictive model for both overall survival (OS) and disease-specific survival (DSS) in patients with HNCM. METHODS This study analyzed the HNCM patients diagnosed between 2004 and 2014 from Surveillance, Epidemiology, and End Results database. To identify independent prognostic factors for HNCM, we integrated results from univariate Cox regression analysis, random survival forests, and LASSO regression with cross-validation. A nomogram was designed and validated based on the identified characteristics to predict the 3-, 5-, and 8-year OS and DSS of patients with HNCM. RESULTS Age, Stage, Ulceration, Thickness, Chemotherapy, lymph node metastasis, and Radiation were identified as independent prognostic factors. The nomogram achieved a satisfactory performance with C-indices of 0.824(DSS) and 0.757(OS) in the training cohort and 0.827(DSS) and 0.749(OS) in the validation cohort, respectively. The area under the curves for the OS at 3, 5, and 8 years were 0.789, 0.788, and 0.794 for the training cohort, and 0.778, 0.776, and 0.795 for the validation cohort, respectively. For DSS, the area under the curves at 3, 5, and 8 years were 0.859, 0.842, and 0.828 in the training cohort, and 0.864, 0.844, and 0.834 in the validation cohort, respectively. The calibration curve showed that there was a strong correlation between the observed outcomes and the predicted survival probability. CONCLUSIONS This study established and validated predictive nomograms for HNCM patients with robust predictive performance.
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Affiliation(s)
- Chenjing Ma
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Ruihao Qin
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Yong Cao
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Yanyan Dai
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Menglei Hua
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Liuying Wang
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Lei Cao
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China
| | - Lijun Fan
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, China
| | - Kang Li
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China.
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Mologousis MA, Moustafa D, Hawryluk EB. Features, management, and outcomes of pediatric scalp melanomas. Pediatr Dermatol 2024; 41:266-269. [PMID: 38128580 DOI: 10.1111/pde.15507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
Pediatric melanoma of the scalp has the highest mortality of any anatomic location. We describe five pediatric patients with a diagnosis of scalp melanoma receiving care at Massachusetts General Hospital and/or Boston Children's Hospital from 2018 through 2022. Melanoma presented in diverse contexts: cellular blue nevus-associated, compound nevus-associated, spitzoid, nodular, and superficial spreading subtypes. This study describes a range of melanoma presentations and emphasizes the need for additional compilation of data on pediatric scalp melanomas to promote their recognition and improve patient care.
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Affiliation(s)
- Mia A Mologousis
- Tufts University School of Medicine, Boston, Massachusetts, USA
- Dermatology Program, Department of Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Danna Moustafa
- Harvard Combined Dermatology Residency Training Program, Boston, Massachusetts, USA
| | - Elena B Hawryluk
- Dermatology Program, Department of Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Hatheway Marshall E, Alvarez G, Wang B, Crimmins J, Schneider MM, Selim MA, Al-Rohil RN. Pediatric Atypical Melanocytic Proliferations: Single-Site Retrospective Cohort Assessment of Treatment and Long-Term Follow-Up. Cancers (Basel) 2023; 15:5804. [PMID: 38136349 PMCID: PMC10741983 DOI: 10.3390/cancers15245804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/06/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Atypical and malignant cutaneous tumors are understudied in the pediatric population, with limited data on long-term follow-up. This study examines pediatric (0-18 years) atypical melanocytic proliferations over a twenty-year period (January 2002-December2022) using the EPIC SlicerDicer at our institution. Over a twenty-year period, there were 55 cases of pediatric melanoma (53 patients). The median follow-up time was 8 years, 11 months. A proportion of 96% were treated with wide local excision (WLE), and 47% had a sentinel lymph node biopsy (SLNB) (35% positive rate). There were 101 atypical Spitz tumor cases (85% atypical Spitz tumors, 15% Spitz melanoma), with a median follow-up duration of 9 years. A proportion of 77% were treated with WLE (with one patient dying of metastatic disease). There were 10 cases of atypical melanocytic proliferations not otherwise specified, including 5 pigmented epithelioid melanocytomas (PEM), 4 deep-penetrating nevi, and 1 atypical cellular blue nevus. This study adds to the growing body of knowledge on pediatric atypical cutaneous melanocytic proliferations, aligning with many described characteristics such as disease location and overall survival rates, with distinct exceptions (higher melanoma positive SLNB rate, lower atypical Spitz tumor WLE rate, and a case of fatal metastatic atypical Spitz tumor).
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Affiliation(s)
| | - Gabriella Alvarez
- Department of Internal Medicine, The University of Texas Health Sciences Center at Houston, Houston, TX 77030, USA;
| | - Bangchen Wang
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
| | - Jennifer Crimmins
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
| | - Michelle M. Schneider
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
| | - M. Angelica Selim
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
| | - Rami N. Al-Rohil
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
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Yoo H, Park S, Kim SW. Nodular type predominance of head and neck cutaneous malignant melanoma in Asian populations leads to poor outcome and low survival. Melanoma Res 2023; 33:326-331. [PMID: 37199704 DOI: 10.1097/cmr.0000000000000901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Cutaneous malignant melanomas of the head and neck (HNM) are proposed to have notable histological and clinical differences from those at other sites (other melanoma); however, HNMs among Asians have remained poorly understood. This study aimed to investigate the clinicopathological features and prognostic factors of HNM in Asians. Asian melanoma patients who underwent surgical treatment from January 2003 to December 2020 were retrospectively reviewed. The clinicopathological features and risk factors for local recurrence, lymph node metastasis, and distant metastasis were analyzed. Among 230 patients, 28 (12.2%) were diagnosed with HNM, and 202 (87.8%) with other melanoma. The histologic subtype significantly differed as the nodular type was predominant in HNM whereas the acral lentiginous type was predominant in other melanoma ( P < 0.001). HNM was significantly associated with higher local recurrence ( P = 0.045), lymph node metastasis ( P = 0.048), distant metastasis ( P = 0.023), and lower 5-year disease-free survival ( P = 0.022) than other melanoma. Ulceration was the risk factor for lymph node metastasis based on multivariable analysis ( P = 0.013). A high proportion of HNM present as the nodular subtype in Asians, leading to poor outcomes and low survival. Therefore, more cautious surveillance, evaluation, and aggressive treatment are required.
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Affiliation(s)
- Hyokyung Yoo
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Li Z, Wei J, Zheng H, Zhang Y, Zhang Y, Cao H, Jin Y. Construction, validation and, visualization of a web-based nomogram to identify the best candidates for primary tumor resection in advanced cutaneous melanoma patients. Front Surg 2023; 9:975690. [PMID: 36743900 PMCID: PMC9889861 DOI: 10.3389/fsurg.2022.975690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Background Existing studies have shown whether primary site resection (PSR) in cutaneous melanoma (CM) patients with stage IV is controversial. Our study aimed to identify the clinical characteristics of CM patients with stage IV who benefited from PSR on a population-based study. Methods We retrospectively reviewed stage IV CM patients in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015. Patients were divided into surgical and non-surgical groups according to whether PSR was performed or not. According to the median cancer-specific survival (CSS) time of the non-surgery group, the surgical group was divided into the surgery-benefit group and the non-surgery-benefit group. Multivariate cox regression analysis was used to explore independent CSS prognostic factors in the surgical group. Then, based on the independent prognostic factors of the surgical group, we established a web-based nomogram based on logistics regression. Results A total of 574 stage IV CM patients were included in our study, and 491 (85.60%) patients were included in the surgical group. The clinical characteristics (benefit group and non-benefit group) included age, M stage, lesion location, and ulceration status. These independent prognostic factors were includeed to construct a web-based nomogram. Conclusions We constructed a web-based nomogram. This model was suitable for identifying the best candidates suitable for PSR in stage IV CM patients.
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Affiliation(s)
- Zhehong Li
- Traumatology and Orthopaedics, Affiliated Hospital of Chengde Medical University, Chengde, China,Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Junqiang Wei
- Traumatology and Orthopaedics, Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Honghong Zheng
- General Surgery, Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Yafang Zhang
- Traumatology and Orthopaedics, Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Yange Zhang
- Traumatology and Orthopaedics, Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Haiying Cao
- Traumatology and Orthopaedics, Affiliated Hospital of Chengde Medical University, Chengde, China
| | - Yu Jin
- Traumatology and Orthopaedics, Affiliated Hospital of Chengde Medical University, Chengde, China,Correspondence: Yu Jin
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Ding Y, Jiang R, Chen Y, Jing J, Yang X, Wu X, Zhang X, Xu J, Xu P, LiuHuang SC, Lu Z. Comparing the characteristics and predicting the survival of patients with head and neck melanoma versus body melanoma: a population-based study. BMC Cancer 2021; 21:420. [PMID: 33863315 PMCID: PMC8052690 DOI: 10.1186/s12885-021-08105-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/25/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous studies reported cutaneous melanoma in head and neck (HNM) differed from those in other regions (body melanoma, BM). Individualized tools to predict the survival of patients with HNM or BM remain insufficient. We aimed at comparing the characteristics of HNM and BM, developing and validating nomograms for predicting the survival of patients with HNM or BM. METHODS The information of patients with HNM or BM from 2004 to 2015 was obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The HNM group and BM group were randomly divided into training and validation cohorts. We used the Kaplan-Meier method and multivariate Cox models to identify independent prognostic factors. Nomograms were developed via the rms and dynnom packages, and were measured by the concordance index (C-index), the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and calibration plots. RESULTS Of 70,605 patients acquired, 21% had HNM and 79% had BM. The HNM group contained more older patients, male sex and lentigo maligna melanoma, and more frequently had thicker tumors and metastases than the BM group. The 5-year cancer-specific survival (CSS) and overall survival (OS) rates were 88.1 ± 0.3% and 74.4 ± 0.4% in the HNM group and 92.5 ± 0.1% and 85.8 ± 0.2% in the BM group, respectively. Eight variables (age, sex, histology, thickness, ulceration, stage, metastases, and surgery) were identified to construct nomograms of CSS and OS for patients with HNM or BM. Additionally, four dynamic nomograms were available on web. The internal and external validation of each nomogram showed high C-index values (0.785-0.896) and AUC values (0.81-0.925), and the calibration plots showed great consistency. CONCLUSIONS The characteristics of HNM and BM are heterogeneous. We constructed and validated four nomograms for predicting the 3-, 5- and 10-year CSS and OS probabilities of patients with HNM or BM. These nomograms can serve as practical clinical tools for survival prediction and individual health management.
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Affiliation(s)
- Yuxin Ding
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China
| | - Runyi Jiang
- Spinal Tumor Center, Department of Orthopaedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China
| | - Yuhong Chen
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China
| | - Jing Jing
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China
| | - Xiaoshuang Yang
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China
| | - Xianjie Wu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China
| | - Xiaoyang Zhang
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China
| | - Jiali Xu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China
| | - Piaopiao Xu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China
| | | | - Zhongfa Lu
- Department of Dermatology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China, No. 88, Jiefang Road, Hangzhou, 310009, China.
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