270 Development and validation of a simple model to predict the risk of keratinocyte carcinoma on screening total body skin examination

Abstract

Melanoma has historically been thought to be radioresistant, and postoperative radiation therapy (RT) has typically been sparingly used. Although the role of RT in melanoma remains controversial, RT has been established as a palliative treatment option for unresectable melanoma, and the TROG 02.01 trials observed that RT following lymphadenectomy for selected patients with node-positive melanoma reduces risk of locoregional recurrence. We analyzed national patterns of care regarding utilization of adjuvant RT for melanoma. We evaluated all melanoma patients who received surgery between 2004-2014 and lymph node dissection in the National Cancer Database (NCDB). Inclusion criteria included: age ! 18 years and positive lymph node involvement. Patients with metastatic disease, in situ histology, and palliative intent therapy were excluded. The proportion of those who received adjuvant RT increased from 1.92% in 2004-2008 to 2.34% in 2009-2014 (p<0.001). Factors associated with increased adjuvant RT use included sex (1.50% in females vs 2.73% in males, p<0.001), older age (1.90% in <65yrs vs 2.72% in 65+yrs, p<0.001), and more lymph nodes dissected (1.07% in 0-5 nodes vs 6.40% in 6+ nodes, p<0.001). The rising use of RT in melanoma within the past decade may reflect the updated reappraisal of the value of adjuvant RT in melanoma. Further investigation into the disease benefits of RT warrants further investigation. 267Regional disparities in healthcare utilization and costs of atopic dermatitis Regional differences in the utilization and costs of dermatologic care are seldom explored. 271From clinical to genotypic modeling: Recessive Dystrophic Epidermolysis Bullosa (RDEB)