Patterns of failure and predictors of outcome in cutaneous malignant melanoma of the scalp

Breanne E. Terakedis, Christopher J. Anker, Sancy Leachman, Robert H I Andtbacka, Glen M. Bowen, William T. Sause, Kenneth F. Grossmann, Tawnya L. Bowles, R. Dirk Noyes, Ying J. Hitchcock, Kenneth M. Boucher, Dennis C. Shrieve

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background Patients with melanoma of the scalp may have higher failure (recurrence) rates than melanoma of other body sites. Objective We sought to characterize survival and patterns of failure for patients with scalp melanoma. Methods Between 1998 and 2010, 250 nonmetastatic patients underwent wide local excision of a primary scalp melanoma. Kaplan-Meier analyses were performed to evaluate overall survival, scalp control, regional neck control, distant metastases-free survival, and disease-free survival. Results Five-year overall survival was 86%, 57%, and 45% for stages I, II, and III, respectively, and 5-year scalp control rates were 92%, 75%, and 63%, respectively. Five-year distant metastases-free survival for these stages were 92%, 65%, and 45%, respectively. Of the 74 patients who recurred, the site of first recurrence included distant disease in 47%, although 31% recurred in the scalp alone. Limitations This is a retrospective review. Conclusion Distant metastases-free survival and overall survival for stage II and III patients with scalp melanoma are poor, and stage III patients experience relatively high rates of scalp failure suggesting that these patients may benefit from additional adjuvant systemic and local therapy. Further research is needed to characterize the environmental, microenvironmental, and genetic causes of the increased aggressiveness of scalp melanoma and to identify more effective treatment and surveillance methods.

Original languageEnglish (US)
Pages (from-to)435-442
Number of pages8
JournalJournal of the American Academy of Dermatology
Volume70
Issue number3
DOIs
StatePublished - Mar 2014

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Scalp
Melanoma
Survival
Neoplasm Metastasis
Cutaneous Malignant Melanoma
Recurrence
Kaplan-Meier Estimate
Disease-Free Survival
Neck
Therapeutics
Research

Keywords

  • melanoma
  • patterns of failure
  • recurrence
  • scalp
  • survival

ASJC Scopus subject areas

  • Dermatology

Cite this

Terakedis, B. E., Anker, C. J., Leachman, S., Andtbacka, R. H. I., Bowen, G. M., Sause, W. T., ... Shrieve, D. C. (2014). Patterns of failure and predictors of outcome in cutaneous malignant melanoma of the scalp. Journal of the American Academy of Dermatology, 70(3), 435-442. https://doi.org/10.1016/j.jaad.2013.10.028

Patterns of failure and predictors of outcome in cutaneous malignant melanoma of the scalp. / Terakedis, Breanne E.; Anker, Christopher J.; Leachman, Sancy; Andtbacka, Robert H I; Bowen, Glen M.; Sause, William T.; Grossmann, Kenneth F.; Bowles, Tawnya L.; Noyes, R. Dirk; Hitchcock, Ying J.; Boucher, Kenneth M.; Shrieve, Dennis C.

In: Journal of the American Academy of Dermatology, Vol. 70, No. 3, 03.2014, p. 435-442.

Research output: Contribution to journalArticle

Terakedis, BE, Anker, CJ, Leachman, S, Andtbacka, RHI, Bowen, GM, Sause, WT, Grossmann, KF, Bowles, TL, Noyes, RD, Hitchcock, YJ, Boucher, KM & Shrieve, DC 2014, 'Patterns of failure and predictors of outcome in cutaneous malignant melanoma of the scalp', Journal of the American Academy of Dermatology, vol. 70, no. 3, pp. 435-442. https://doi.org/10.1016/j.jaad.2013.10.028
Terakedis, Breanne E. ; Anker, Christopher J. ; Leachman, Sancy ; Andtbacka, Robert H I ; Bowen, Glen M. ; Sause, William T. ; Grossmann, Kenneth F. ; Bowles, Tawnya L. ; Noyes, R. Dirk ; Hitchcock, Ying J. ; Boucher, Kenneth M. ; Shrieve, Dennis C. / Patterns of failure and predictors of outcome in cutaneous malignant melanoma of the scalp. In: Journal of the American Academy of Dermatology. 2014 ; Vol. 70, No. 3. pp. 435-442.
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abstract = "Background Patients with melanoma of the scalp may have higher failure (recurrence) rates than melanoma of other body sites. Objective We sought to characterize survival and patterns of failure for patients with scalp melanoma. Methods Between 1998 and 2010, 250 nonmetastatic patients underwent wide local excision of a primary scalp melanoma. Kaplan-Meier analyses were performed to evaluate overall survival, scalp control, regional neck control, distant metastases-free survival, and disease-free survival. Results Five-year overall survival was 86{\%}, 57{\%}, and 45{\%} for stages I, II, and III, respectively, and 5-year scalp control rates were 92{\%}, 75{\%}, and 63{\%}, respectively. Five-year distant metastases-free survival for these stages were 92{\%}, 65{\%}, and 45{\%}, respectively. Of the 74 patients who recurred, the site of first recurrence included distant disease in 47{\%}, although 31{\%} recurred in the scalp alone. Limitations This is a retrospective review. Conclusion Distant metastases-free survival and overall survival for stage II and III patients with scalp melanoma are poor, and stage III patients experience relatively high rates of scalp failure suggesting that these patients may benefit from additional adjuvant systemic and local therapy. Further research is needed to characterize the environmental, microenvironmental, and genetic causes of the increased aggressiveness of scalp melanoma and to identify more effective treatment and surveillance methods.",
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AU - Bowen, Glen M.

AU - Sause, William T.

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AU - Shrieve, Dennis C.

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N2 - Background Patients with melanoma of the scalp may have higher failure (recurrence) rates than melanoma of other body sites. Objective We sought to characterize survival and patterns of failure for patients with scalp melanoma. Methods Between 1998 and 2010, 250 nonmetastatic patients underwent wide local excision of a primary scalp melanoma. Kaplan-Meier analyses were performed to evaluate overall survival, scalp control, regional neck control, distant metastases-free survival, and disease-free survival. Results Five-year overall survival was 86%, 57%, and 45% for stages I, II, and III, respectively, and 5-year scalp control rates were 92%, 75%, and 63%, respectively. Five-year distant metastases-free survival for these stages were 92%, 65%, and 45%, respectively. Of the 74 patients who recurred, the site of first recurrence included distant disease in 47%, although 31% recurred in the scalp alone. Limitations This is a retrospective review. Conclusion Distant metastases-free survival and overall survival for stage II and III patients with scalp melanoma are poor, and stage III patients experience relatively high rates of scalp failure suggesting that these patients may benefit from additional adjuvant systemic and local therapy. Further research is needed to characterize the environmental, microenvironmental, and genetic causes of the increased aggressiveness of scalp melanoma and to identify more effective treatment and surveillance methods.

AB - Background Patients with melanoma of the scalp may have higher failure (recurrence) rates than melanoma of other body sites. Objective We sought to characterize survival and patterns of failure for patients with scalp melanoma. Methods Between 1998 and 2010, 250 nonmetastatic patients underwent wide local excision of a primary scalp melanoma. Kaplan-Meier analyses were performed to evaluate overall survival, scalp control, regional neck control, distant metastases-free survival, and disease-free survival. Results Five-year overall survival was 86%, 57%, and 45% for stages I, II, and III, respectively, and 5-year scalp control rates were 92%, 75%, and 63%, respectively. Five-year distant metastases-free survival for these stages were 92%, 65%, and 45%, respectively. Of the 74 patients who recurred, the site of first recurrence included distant disease in 47%, although 31% recurred in the scalp alone. Limitations This is a retrospective review. Conclusion Distant metastases-free survival and overall survival for stage II and III patients with scalp melanoma are poor, and stage III patients experience relatively high rates of scalp failure suggesting that these patients may benefit from additional adjuvant systemic and local therapy. Further research is needed to characterize the environmental, microenvironmental, and genetic causes of the increased aggressiveness of scalp melanoma and to identify more effective treatment and surveillance methods.

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