Adjuvant Radiotherapy for Palpable Melanoma Metastases to the Groin: When to Irradiate?

Gojkovič-Horvat, Andreja; Jančar, Boris; Blas, Mateja; Žumer, Barbara; Karner, Katarina; Hočevar, Marko; Strojan, Primož

doi:10.1016/j.ijrobp.2011.06.1979

Cited by 15 publications

(7 citation statements)

References 20 publications

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“…Two randomized controlled trials [338,339] confirmed six retrospective cohort studies [336,337,340,341,343,345] in showing significantly higher locoregional control rates in patients with lymph node metastases undergoing postoperative adjuvant radiation therapy of the affected lymph node basins. In Burmeister et al, 34 of 127 patients without radiation therapy sustained locoregional lymph node recurrence, whereas in the patient group subjected to adjuvant radiation therapy, 20 patients suffered recurrence within the lymph node basin.…”

Section: Level Of Evidence 2bmentioning

confidence: 78%

“…Systematic search of the literature de-novo: [336][337][338][339][340][341][342][343][344][345] Strength of consensus: 100%…”

Section: Level Of Evidence 2bmentioning

confidence: 99%

“…Risk factors for recurrence in regional lymph node basins are capsular penetration, number of positive lymph nodes, and size of lymph node metastases [336,337,[339][340][341][343][344][345]. Bibault et al not only reported a significant impact of capsular penetration on regional recurrence rates, but also on survival.…”

Section: Level Of Evidence 2bmentioning

confidence: 99%

See 2 more Smart Citations

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

180

148

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Section: Level Of Evidence 2bmentioning

confidence: 78%

“…Systematic search of the literature de-novo: [336][337][338][339][340][341][342][343][344][345] Strength of consensus: 100%…”

Section: Level Of Evidence 2bmentioning

confidence: 99%

See 1 more Smart Citation

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

180

148

View full text Add to dashboard Cite

“…In contrast to this study, there were no studies with regional comparisons of lymphoedema for each of the nodal dissection types. Few studies have confirmed the increase in lymphoedema rates following TLND with RT, including after RT to the groin following TLND …”

Section: Discussionmentioning

confidence: 99%

Assessment of morbidity following regional nodal dissection in the axilla and groin for metastatic melanoma

Theodore

Frankel

Thomas

et al. 2016

ANZ Journal of Surgery

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“…Bei Agrawal et al [336] betrug die lokale Kontrollrate in der zervikalen Lymphknotenregion nach 5 Jahren 43 % ohne und 93 % mit Bestrahlung, bzw. So waren bei Hamming-Vrieze in der postoperativ bestrahlten Gruppe bei 85 % der Patienten mindestens 2 Lymphknoten befallen, bei 35 % lag ein Kapseldurchbruch vor, in der alleinig operierten Gruppe waren bei 37 % mehr als 2 Lymphknoten befallen, bei 8 % ein Kapseldurchbruch vorhanden[341].Als Risikofaktoren für ein Rezidiv im Bereich der regionären Lymphknotenstation gelten ein Kapseldurchbruch, die Anzahl befallener Lymphknoten und die Größe der Lymphknotenmetastasen[336,337,339,340,341,[343][344][345]. Für die inguinale Lymphknotenregion fand sich mit jeweils 69 % Kontrollrate kein Unterschied zwischen den Behandlungsarmen.…”

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Malignes Melanom S3‐Leitlinie “Diagnostik, Therapie und Nachsorge des Melanoms”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

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This first German evidence-based guideline for cutaneous melanoma was developed under the auspices of the German Dermatological Society (DDG) and the Dermatologic Cooperative Oncology Group (DeCOG) and funded by the German Guideline Program in Oncology. The recommendations are based on a systematic literature search, and on the consensus of 32 medical societies, working groups and patient representatives. This guideline contains recommendations concerning diagnosis, therapy and follow-up of melanoma. The diagnosis of primary melanoma based on clinical features and dermoscopic criteria. It is confirmed by histopathologic examination after complete excision with a small margin. For the staging of melanoma, the AJCC classification of 2009 is used. The definitive excision margins are 0.5 cm for in situ melanomas, 1 cm for melanomas with up to 2 mm tumor thickness and 2 cm for thicker melanomas, they are reached in a secondary excision. From 1 mm tumor thickness, sentinel lymph node biopsy is recommended. For stages II and III, adjuvant therapy with interferon-alpha should be considered after careful analysis of the benefits and possible risks. In the stage of locoregional metastasis surgical treatment with complete lymphadenectomy is the treatment of choice. In the presence of distant metastasis mutational screening should be performed for BRAF mutation, and eventually for CKIT and NRAS mutations. In the presence of mutations in case of inoperable metastases targeted therapies should be applied. Furthermore, in addition to standard chemotherapies, new immunotherapies such as the CTLA-4 antibody ipilimumab are available. Regular follow-up examinations are recommended for a period of 10 years, with an intensified schedule for the first three years.

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Adjuvant Radiotherapy for Palpable Melanoma Metastases to the Groin: When to Irradiate?

Cited by 15 publications

References 20 publications

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Assessment of morbidity following regional nodal dissection in the axilla and groin for metastatic melanoma

Malignes Melanom S3‐Leitlinie “Diagnostik, Therapie und Nachsorge des Melanoms”

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