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The benefits of adjuvant radiation therapy after therapeutic lymphadenectomy for clinically advanced, high-risk, lymph node-metastatic melanoma
Cancer, 08/26/09
Agrawal S et al. – Adjuvant RT was associated with improved regional lymph node basin control compared with therapeutic lymphadenectomy (TL) alone in patients with high risk, clinically advanced, lymph node metastatic melanoma
Methods- 615 patients with clinically advanced, regional lymph node metastatic disease underwent TL
- Median f/u 5 y
- The actuarial 5 y regional lymph node basin control rate was 81%
- The number of positive lymph nodes, the number of lymph nodes removed, and the use of adjuvant RT were associated with improved regional control
- Tx-related morbidity, particularly lymphedema, was increased with the use of adjuvant RT and an inguinal site of lymph node metastases
- At last f/u, 268 patients were alive with actuarial 5 y distant metastasis-free survival (DMFS) and DSS rates of 40% and 48%, respectively
- DMFS and DSS were influenced by the number of positive lymph nodes and the number of lymph nodes removed
- DSS was influenced by primary tumor thickness and adjuvant RT
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