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Abstract：
Cutaneous head and neck melanoma is a separate subgroup of cutaneous melanoma that has a worse prognosis than other primary sites. The aim of this article is to examine the significance of sex and site of primary lesion as additional risk factors. Primary localization distribution and metastatic disease in the neck in a retrospective cohort of 159 patients with cutaneous head and neck malignant melanoma were analyzed. Men develop primary melanoma more frequently than women in the left peripheral head and neck regions (P = .0364), as well as clinically visible and occult metastatic disease in the left side of the neck (P = .0138). Patients with clinically occult regional metastatic disease showed a significantly poorer survival rate than the rest of the group that underwent elective neck dissections (P = .0270). Left-sided disease in male patients may be an additional risk factor in cutaneous head and neck melanoma. Performing elective neck dissections in high-risk patients might identify patients with occult metastatic disease and worse prognosis but does not offer any significant therapeutic benefit.
摘要：
皮肤头颈部黑色素瘤是皮肤黑色素瘤的一个独立亚组，其预后比其他原发部位差。本文的目的是研究性别和原发性病变部位作为其他危险因素的重要性。对159例皮肤头颈部恶性黑色素瘤患者的回顾性队列中的主要定位分布和颈部转移性疾病进行了分析。在左侧周围头颈部，男性患原发性黑色素瘤的频率高于女性（P=0.0364），以及临床上可见和隐匿的颈部左侧转移性疾病（P=0.0138）。临床隐匿性区域转移性疾病患者的生存率明显低于其他接受选择性颈淋巴结清扫术的患者（P=.0270）。男性患者的左侧疾病可能是皮肤头颈部黑色素瘤的另一个危险因素。在高危患者中进行选择性颈淋巴结清扫术可能会发现隐匿性转移性疾病和预后较差的患者，但没有任何明显的治疗益处。
