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Titolo:
Is adjuvant radiotherapy necessary after positive lymph node dissection inhead and neck melanomas?
Autore:
Shen, P; Wanek, LA; Morton, DL;
Indirizzi:
St Johns Hlth Ctr, John Wayne Canc Inst, Santa Monica, CA 90404 USA St Johns Hlth Ctr Santa Monica CA USA 90404 t, Santa Monica, CA 90404 USA
Titolo Testata:
ANNALS OF SURGICAL ONCOLOGY
fascicolo: 8, volume: 7, anno: 2000,
pagine: 554 - 559
SICI:
1068-9265(200009)7:8<554:IARNAP>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
CUTANEOUS MALIGNANT-MELANOMA; RADIATION-THERAPY; METASTASES;
Keywords:
head and neck; malignant melanoma; lymph node dissection;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Morton, DL St Johns Hlth Ctr, John Wayne Canc Inst, 2200 Santa Monica Blvd, Santa Monica, CA 90404 USA St Johns Hlth Ctr 2200 Santa Monica Blvd SantaMonica CA USA 90404
Citazione:
P. Shen et al., "Is adjuvant radiotherapy necessary after positive lymph node dissection inhead and neck melanomas?", ANN SURG O, 7(8), 2000, pp. 554-559

Abstract

Introduction: Postoperative radiotherapy (PR) has been recommended in patients with advanced head and neck melanomas to improve regional control. This study examined the incidence of cervical recurrence among patients who did not receive PR after surgical management of node-positive head and neck melanomas. Methods: A computerized search of a database listing more than 10,000 patients with melanoma prospectively acquired between 1971 and 1998 identified 217 patients with pathologically positive nodes who had undergone regional lymph node dissection (RLND). Of these patients, 21 had received PR and 196had not. Results: Median follow-up after RLND was 20 months for nonsurvivors and 32months for survivors. The overall incidence of cervical recurrence was 14%(27/196). The 5-year cervical recurrence-free survival rate was 83%. Five-year cervical recurrence-free survival rates were 69% vs. 87% for patients with vs. without extranodal disease (P = .004), 96% vs. 81% for patients with nonpalpable vs, palpable nodes (P = .0761), and 82% vs. 91% for patientswith one to three positive nodes vs, more than three positive nodes (P = .256). Multivariate analysis, which included the timing of nodal disease presentation and the effect of systemic adjuvant therapy, identified extranodal disease as the only independent predictor of cervical recurrence (P = .034). Cervical recurrence was significantly related to the subsequent occurrence of distant relapse. Conclusions: The low incidence of cervical recurrence after RLND in patients with node-positive head and neck melanomas does not justify the routine use of PR. The only subset of patients who may benefit from PR are those with extranodal disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 23:54:58