Current treatment strategy for resectable scalp and neck melanoma

Abstract

Melanoma is a malignant skin tumor associated with a poor clinical prognosis. The incidence of melanoma is constantly rising. Several studies demonstrated that overall and relapse-free survival rates in patients with head and neck melanoma were lower than those in patients with skin melanoma of other locations. Some authors showed that patients with scalp melanoma had the worst prognosis. Surgery is currently the main treatment option for resectable skin melanoma. It has a number of specific characteristics, such as the need for a smaller resection margin at primary tumor removal in some cases, lower accuracy of sentinel lymph node identification due to the complexity of lymph flow from the scalp and neck, and changes in the standard volumes of lymphadenectomy considering lymph flow from the scalp and neck. Oncologists should have reconstructive surgery skills, because their aim is not only to ensure complete tumor excision, but also to achieve a satisfactory appearance of the patient, especially if the tumor is located in the face, open areas of the head and neck and ears, since this is of functional and aesthetic importance. The administration of adjuvant therapy still causes some controversy in cases where both radiation therapy and pharmacotherapy are indicated. In this article, we describe the main characteristics of the current treatment strategy for resectable scalp and neck melanoma and cover the main problems in this area that have not been addressed so far.