Košec A, et al. - In this retrospective longitudinal cohort study and its protocol involving 159 patients, researchers analyzed the significance of gender and site of primary lesion as additional risk factors. Patients with cutaneous head and neck malignant melanoma were analyzed. Investigators found that men develop primary melanoma more often than women in the left peripheral head and neck regions, as well as clinically visible and occult metastatic disease in the left side of the neck. Clinically occult regional metastatic disease patients showed a significantly poorer survival rate than the rest of the group that had elective neck dissections. In cutaneous head and neck melanoma, a left-sided disease in male patients may be an additional risk factor. In high-risk patients, performing elective neck dissections may recognize patients with occult metastatic disease and worse prognosis but does not give any important therapeutic benefit.