Melanoma, mayor mortalidad en cabeza y cuello.

Primary Melanoma Tumor Location Is Associated With

Mortality Risk

Lisa Kuhns, PhD |

December 12, 2025

Primary tumor location (PTL) is an independent prognostic factor in cutaneous

malignant melanoma (CMM), with melanoma on the head and neck associated with

higher mortality and melanoma on the limbs associated with lower mortality

compared with lesions on the trunk. These study results were published in the

Journal of the American Academy of Dermatology.

Researchers performed a retrospective cohort study using data from the

Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2021,

identifying 370,862 patients with CMM and applying sequential exclusions to derive

a final sample of 162,871 patients with complete demographic, clinical, staging, and

treatment information. Outcomes were all-cause and melanoma-specific mortality.

The median follow-up was 6.3 years. The cohort was predominantly men (56.4%),

White (98.5%), younger than 70 years of age (71.6%), and married (68.0%). Most lived

in urban areas (80.2%), presented with lateralized lesions (86.8%), had no ulceration

(55.9%), and underwent surgery (98.2%). The most common histologic subtypes were

malignant melanoma NOS (45.6%), superficial spreading melanoma (33.8%), and

nodular melanoma (9.7%).

Overall, 23.0% of patients died, with a median time from diagnosis to death of 3.8

years. The leading causes of death were CMM (21.9%) and cardiovascular disease

(12.2%).

https://www.dermatologyadvisor.com/news/primary-melanoma-03a4297c649084&hmsubid=&nid=2049200711&elqtrack=True 18/12/25, 3:26 AM

Page 1 of 3"

This large-scale SEER-based study found that HNM

was significantly associated with an increased risk of all-

cause and cancer-specific mortality vs trunk, while LLH

"

and ULS sites showed reduced risks.

Kaplan-Meier curves showed higher all-cause and cancer-specific mortality among

patients with head and neck (HN) tumors. Multivariable analyses demonstrated that,

compared with trunk lesions, HN as the PTL was associated with increased all-cause

mortality (adjusted hazard ratio [aHR], 1.08; 95% CI, 1.05-1.12) and cancer-specific

mortality (aHR, 1.05; 95% CI, 1.02-1.09). In contrast, upper limb/shoulder (ULS) and

lower limb/hip (LLH) tumors were associated with reduced all-cause mortality (aHR,

0.91; 95% CI, 0.89-0.94 and aHR, 0.89; 95% CI 0.86-0.92, respectively) and reduced

cancer-specific mortality (aHR, 0.79; 95% CI, 0.75-0.84 and aHR, 0.96; 95% CI, 0.92-

1.00).

Subgroup analyses showed significant effect modification by age at diagnosis, sex,

race, marital status, diagnosis year, T stage, histology, and treatment. Sensitivity

analyses including exclusion of missing data, adjustment for tumor thickness,

propensity score matching (yielding up to 34,697 matched pairs), and overlap

weighting confirmed the robustness of the associations, with consistent hazard

ratios across all analytic approaches.

Study limitations include the lack of immunotherapy data, potential selection bias,

and residual confounding.

The researchers concluded, "This large-scale SEER-based study found that HNM

[HM melanoma] was significantly associated with an increased risk of all-cause and

cancer-specific mortality vs trunk, while LLH and ULS sites showed reduced risks."

References:

Wei S, Su L, Wu L. Association of primary tumor location with all-cause and cancer-

specific mortality in cutaneous malignant melanoma patients. J Am Acad Dermatol.

https://www.dermatologyadvisor.com/news/primary-melanoma-03a4297c649084&hmsubid=&nid=2049200711&elqtrack=True 18/12/25, 3:26 AM

Page 2 of 3specific mortality in cutaneous malignant melanoma patients. J Am Acad Dermatol.

Published online November 14, 2025. doi:10.1016/j.jaad.2025.11.027

Sent from my iPhone

Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

Please excuse the shortness of this message, as it has been sent from
a mobile device.