Prognostic factors in determining the outcome of head and neck cutaneous melanoma

Abstract

Melanoma arises from melanocytes in the skin (cutaneous) or mucosa (mucosal). It is one of the most aggressive skin cancers when compared to other, non-melanoma skin cancers. Worldwide, melanoma represents 4% of all skin cancers, but is responsible for 80% of skin cancer deaths, and 1-2% of all cancer deaths overall. In Canada, there are approximately 6500 new cases of malignant melanoma diagnosed per year. Our objective is to evaluate the impact of individual prognostic factors on the outcome of malignant melanoma in the head and neck region. The study will involve a review of about 1600 paper and electronic medical records of a historical cohort of patients diagnosed in the province of Manitoba from 1970 to 2012 whose diagnoses can be separated into invasive and in situ. The information collected will include demographic risk factors, factors associated with malignant transformation of in situ disease, extent of disease at presentation, treatment, pathology, patterns of failure, salvage, and final outcome in a pre-designed data collection sheet. Survival will be estimated by Kaplan Meier method and the impact of non-cancer deaths will be assessed by competing risk analysis. The effect of various prognostic factors such as the stage of tumour, margin status, Breslow's index, pathological type, treatment modality, and co-morbidity on disease free survival and cause specific survival will be analyzed by Cox Proportional Hazard model for independent variables using SPSS 22.0.