Fifty Shades: Controversies and Updates in Head & Neck Melanoma

PROGRAM DESCRIPTION: Management of cutaneous melanoma of the head and neck continues to evolve every year. Changes in AJCC staging, controversies relating to Mohs micrographic surgery versus wide local excision for management of the primary site, evolving sentinel lymph node biopsy techniques, changing thresholds for completion neck dissection, increasing the role of immunotherapy in management of melanoma, and implementing intra-lesion injectable therapies in managing advanced head and neck cutaneous melanoma are all important areas that are dramatically altering diagnostic and therapeutic practice patterns. Otorhinolaryngologists play an essential role in management of patients with head and neck cutaneous melanoma, and need to stay up to date on surgical controversies, emerging therapeutics, and combinatorial therapies.

This panel discussion will focus on informing otorhinolaryngologists about key updates relating to Mohs versus wide local excision, sentinel lymph node biopsy, approaches to management of cN0 nodal basins upon discovery of positive sentinel nodes for patients with head and neck cutaneous melanoma, the integration of systemic therapy in management of advanced head and neck melanoma, and the nuances of utilizing injectable immunotherapy agents in clinical practice. Additionally, practice pearls and pitfalls relating to setting up a program focused on injectable immunotherapy for otorhinolaryngologists will be described utilizing a case based approach.

This panel has been well-attended in previous years and benefitted from significant audience participation. Audience participation will be encouraged again, and members will have the opportunity to engage in focused discussion in the controversies of the panelists' presentations.

OUTCOME OBJECTIVE 1: Describe different techniques, pearls & pitfalls in sentinel lymph node biopsy for cutaneous melanoma; examine controversies in management of cN0 nodal basin upon discovery of positive sentinel lymph nodes.

OUTCOME OBJECTIVE 2: Identify role of systemic therapy and its interactions with surgical therapy for head and neck cutaneous melanoma.

OUTCOME OBJECTIVE 3: Define role of the head and neck surgeon in intra-lesion injectable therapies in managing advanced head and neck cutaneous melanoma.

BACKGROUND STATEMENT: As part of multidisciplinary teams managing head and neck cutaneous melanoma, otorhinolaryngologists require up to date information on surgical controversies, emerging therapeutics, and combinatorial therapies.

Comprehensive Otolaryngology Track Statement : The panel represents comprehensive review of head & neck melanoma for any otolaryngologist. We discuss practical & technical advice on how and when to perform SLN bx and/or neck dissection, and logistical issues like how to successfully implement these controversies into one's busy practice.