{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T12:47:02Z","timestamp":1780490822625,"version":"3.54.1"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"S2","license":[{"start":{"date-parts":[[2016,5,12]],"date-time":"2016-05-12T00:00:00Z","timestamp":1463011200000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the United Kingdom. This paper provides consensus recommendations on the management of melanomas arising in the skin and mucosa of the head and neck region on the basis of current evidence.<\/jats:p><jats:sec id=\"S0022215116000852_sec_a1\"><jats:title>Recommendations<\/jats:title><jats:p>\u2022 At-risk individuals should be warned about the correlation between ultraviolet radiation (UVR) exposure and skin cancer, and should be given advice on UVR protection. (R)<\/jats:p><jats:p>\u2022 Dermatoscopy can aid in the diagnosis of cutaneous melanoma. (R)<\/jats:p><jats:p>\u2022 Histological examination after biopsy is essential to confirm the diagnosis and the tumour thickness. (G)<\/jats:p><jats:p>\u2022 Excisional biopsy is method of choice. (G)<\/jats:p><jats:p>\u2022 Staging investigations can be performed for both regional and distant disease. (R)<\/jats:p><jats:p>\u2022 Scanning (computed tomography (CT) and\/or magnetic resonance imaging) is recommended for patients with high-risk melanoma. (G)<\/jats:p><jats:p>\u2022 Patients with signs or symptoms of disease relapse should be investigated by imaging. (R)<\/jats:p><jats:p>\u2022 Imaging of the brain should be performed in patients who have stage IV disease. (G)<\/jats:p><jats:p>\u2022 Patients with melanoma of unknown primary should be thoroughly examined and investigated for a potential primary source. (R)<\/jats:p><jats:p>\u2022 Primary cutaneous invasive melanoma should be excised with a surgical margin of at least 1 cm. (G)<\/jats:p><jats:p>\u2022 The maximum recommended excision margin is 3 cm. (R)<\/jats:p><jats:p>\u2022 The actual margin of excision depends upon the depth of the melanoma and its anatomical site. (G)<\/jats:p><jats:p>\u2022 Ultrasound-guided fine needle aspiration (FNA) or core biopsy of suspected lymphadenopathy is more accurate than \u2018blind\u2019 biopsy. (R)<\/jats:p><jats:p>\u2022 Open biopsy should only be performed if FNA or core biopsy is inadequate or equivocal. (R)<\/jats:p><jats:p>\u2022 Prior to lymph node dissection, staging by CT scan should be carried out. (R)<\/jats:p><jats:p>\u2022 If parotid disease is present without neck involvement, both parotidectomy and neck dissection should ideally be performed. (R)<\/jats:p><jats:p>\u2022 There is no role for elective lymph node dissection. (R)<\/jats:p><jats:p>\u2022 Sentinel lymph node biopsy (SLNB) can be considered in stage IB and above by specialist skin cancer multidisciplinary teams. (G)<\/jats:p><jats:p>\u2022 Patients should be made aware that SLNB is a staging procedure, and should understand that it has, as yet, no proven therapeutic value. (R)<\/jats:p><jats:p>\u2022 All patients with cutaneous melanoma should have their original tumour checked for BRAF gene status, and their subsequent targeted biological therapy based on this. (R)<\/jats:p><jats:p>\u2022 Patients who develop brain metastases should be considered for stereotactic radio-surgery. (R)<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215116000852","type":"journal-article","created":{"date-parts":[[2016,5,12]],"date-time":"2016-05-12T06:37:06Z","timestamp":1463035026000},"page":"S133-S141","source":"Crossref","is-referenced-by-count":20,"title":["Head and neck melanoma (excluding ocular melanoma): United Kingdom National Multidisciplinary Guidelines"],"prefix":"10.1017","volume":"130","author":[{"given":"O A","family":"Ahmed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,5,12]]},"reference":[{"key":"S0022215116000852_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2008.09.018"},{"key":"S0022215116000852_ref11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030681"},{"key":"S0022215116000852_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23929"},{"key":"S0022215116000852_ref6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.0285"},{"key":"S0022215116000852_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-007-0009-4"},{"key":"S0022215116000852_ref2","volume-title":"Melanoma: Assessment and Management","year":"2015"},{"key":"S0022215116000852_ref3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1994.tb06881.x"},{"key":"S0022215116000852_ref4","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.137.10.1343"},{"key":"S0022215116000852_ref8","first-page":"CD004835","article-title":"Surgical excision margins for primary cutaneous melanoma","author":"Sladden","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"S0022215116000852_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61546-8"},{"key":"S0022215116000852_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00187-4"},{"key":"S0022215116000852_ref22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1411158"},{"key":"S0022215116000852_ref24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1003466"},{"key":"S0022215116000852_ref1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2011.486"},{"key":"S0022215116000852_ref20","first-page":"CD005413","article-title":"Chemoimmunotherapy versus chemotherapy for metastatic malignant melanoma","author":"Sasse","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"S0022215116000852_ref23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103782"},{"key":"S0022215116000852_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2014.04.008"},{"key":"S0022215116000852_ref9","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000217236.06585.a9"},{"key":"S0022215116000852_ref5","volume-title":"TNM Classification of Malignant Tumours, UICC","author":"Sobin","year":"2009"},{"key":"S0022215116000852_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2010.07.006"},{"key":"S0022215116000852_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20001001)89:7<1495::AID-CNCR12>3.0.CO;2-D"},{"key":"S0022215116000852_ref14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310460"},{"key":"S0022215116000852_ref16","doi-asserted-by":"publisher","DOI":"10.1038\/ncponc1014"},{"key":"S0022215116000852_ref15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f675"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215116000852","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T15:35:00Z","timestamp":1555688100000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215116000852\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5]]},"references-count":24,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2016,5]]}},"alternative-id":["S0022215116000852"],"URL":"https:\/\/doi.org\/10.1017\/s0022215116000852","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5]]}}}