April 1991

The Importance of Anatomic Site in Prognosis in Patients With Cutaneous Melanoma

Author Affiliations

From the Division of Oncology, Department of Surgery, John Wayne Cancer Clinic, Jonsson Comprehensive Cancer Center, UCLA School of Medicine (Drs Wong, Morton, Wanek, and Goradia and Ms Chang); and Surgical Service, Sepulveda (Calif) Veterans Administration Medical Center (Dr Wong). Dr Wong is the recipient of a Career Development Award from the American Cancer Society.

Arch Surg. 1991;126(4):486-489. doi:10.1001/archsurg.1991.01410280090013

• To determine the prognostic relevance of the anatomic site of origin of cutaneous melanoma to survival, we retrospectively analyzed a computerized database of 3428 patients with stage I and II cutaneous melanoma. Patients were stratified by the recognized prognostic variables of stage of disease, Clark's level of invasion of the primary lesion, and the nodal involvement at the time of lymphadenectomy. Melanoma arising in skin of the upper part of the back, back of the arms, neck, and scalp (BANS) region occurred more frequently in male than female patients. There were no statistically significant differences in the distribution of Clark's level of invasion of BANS and non-BANS region primary melanomas or in the extent of nodal involvement in patients with stage II disease. The 5-year actuarial survival of patients with stage I BANS region melanomas was 87%; stage I non-BANS, 89%; stage II BANS, 38%; and stage II non-BANS, 69%. The BANS region appears to have prognostic significance in cutaneous melanoma and, particularly, in patients with stage II melanoma.

(Arch Surg. 1991;126:486-489)