BACKGROUND Local recurrence of melanoma is associated with a grave prognosis. However, the characteristics and the mode of disease progression for patients with local recurrence have not been adequately addressed in the literature. METHODS A retrospective analysis of patients treated at a single institution revealed a subset of patients (n = 648) with local recurrence of melanoma as a first event. Patient characteristics, histologic determinants, and disease free interval were variables used to identify prognostic factors. RESULTS In this group of patients, male gender (P = 0.0163), increasing age (P = 0.0001), head and neck primaries (P = 0.0001), thicker Breslow depths (P = 0.0022), deeper Clark levels (P = 0.0010), and ulceration of the primary tumor (P = 0.0348) suggested a shorter time until local recurrence. Breslow depth (P = 0.0004), Clark level (P = 0.0043), and ulceration (P = 0.0001) still factored into the survival prognosis after recurrence. Truncal primaries (P = 0.0005) and shorter disease free intervals (P = 0.0098) were also associated with poorer outcomes after recurrence. Of the 648 patients, 124 showed no progression, 196 developed another local recurrence, 178 developed in‐transit/lymph node metastases, and 150 had systemic recurrences. Survival was only 33.6% for patients with further metastases, compared with 77.4% for patients with no progression of disease after a median follow‐up of 38.9 months. CONCLUSIONS There was a 48.5% mortality rate at 5 years of follow‐up after local recurrence. Long term survival (> 10 years) was estimated to be 34.9%. The patterns of failure after local recurrence suggest that patients may benefit from aggressive locoregional therapy. Cancer 2000;88:1063–71. © 2000 American Cancer Society.

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Background: Nerve block is a clinical technique for relieving pain during surgery as well as for postoperative analgesia and chronic pain. Here, we analysed the trends in nerve block research and compared the contributions from different countries, institutions, journals, and authors. Methods: We extracted all studies concerning nerve block published between 1997 and 2021 from the Web of Science database. Microsoft Excel and VOSviewer were used to collect publication data, analyse publication trends, and visualize relevant results. Results: A total of 6,437 publications with 111,612 citations were identified between 1997 and 2021. The United States contributed the greatest number of publications (2010), whereas China ranked second (518). Regional Anesthesia & Pain Medicine had published the most papers concerning nerve block. Harvard University and Mariano ER were the most productive institution and author, respectively, in the field. Keywords were categorized into five clusters: the association between nerve block and anaesthesia or analgesia, local anaesthetic drugs for nerve block, nerve block techniques, nerve block for postoperative analgesia, and nerve block for oral local anaesthesia. Management-related research was a heavily researched topic in the field. Conclusions: We concluded that the United States contributed the most studies, and developing countries, led by China, are also encouraging study in this area. The exploration of new drugs in the fields of nerve block, multi-modal analgesia after surgery, treatment of chronic pain, analgesia for thoracic and abdominal surgeries, and analgesic interventions in oral therapy are a potential focus for future research.