Therapeutic lymphadenectomy in melanomas of the head and neck

This retrospective study describes patients with locoregionally metastasized melanoma of the head and neck. All patients underwent a therapeutic lymph node dissection. The 3‐year survival rate was 35%. Duration of disease‐free interval, number of lymph nodes involved, and extent of neck dissection proved of no influence on survival rates. Locoregional recurrence occurred in 10 patients and always proved to be a sign of systemic dissemination. Ultimately, 19 patients developed systemic disease. More than 40% developed cerebral metastases and the cerebrum was the second most involved site. As cerebral involvement occurs often in head and neck melanoma, a computed tomography or magnetic resonance imaging scan of the brain is recommended in the routine work‐up before lymph node dissection. Furthermore, because the extent of the surgical procedure had no influence on local recurrence rate and overall survival, a selective approach, preserving functional structures, is advocated.