WEDNESDAY, Sept. 18, 2024 -- Cutaneous head and neck melanoma (CHNM) has a distinct clinicopathological and prognostic profile relative to cutaneous melanomas of other sites (CMOS), according to a study published online Sept. 5 in the Journal of the American Academy of Dermatology.

Andrew T. Li, M.B.B.S., from the Melanoma Institute Australia at The University of Sydney, and colleagues compared clinicopathological features and treatment outcomes of CHNM and CMOS among patients diagnosed between 2000 and 2008. Using the Kaplan-Meier method, locoregional control (LRC), distant metastasis-free survival (DMFS), melanoma-specific survival (MSS), and overall survival (OS) were described.

The analyses included 3,007 CHNM patients and 10,637 CMOS patients. The researchers found that CHNM had more adverse pathological features than CMOS (median age, 65.9 versus 58.5 years; median Breslow thickness, 1.7 versus 1.2 mm; ulceration: 21.2 versus 18.2 percent). Worse LRC and DMFS were seen for CHNM (hazard ratios, 1.17 and 1.25, respectively), but no significant differences were seen in MSS or OS. In multivariable analyses, better MSS and OS were seen for CHNM among stage IV patients who received immune checkpoint inhibitors (hazard ratios, 0.56 and 0.57, respectively).

"There are likely to be biological differences between CHNM and CMOS," the authors write. "Primary melanoma site should be considered in the multidisciplinary decision-making process when deciding whether to recommend immune checkpoint inhibitor therapy."

Several authors disclosed ties to the pharmaceutical industry.