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BACKGROUND Regional recurrence remains a problem in the management of patients with metastatic malignant melanoma in the cervical lymph nodes and parotid. In this study, the influence of the number of positive nodes, extracapsular spread, and the use of adjuvant radiotherapy on regional control and survival were analyzed. METHODS A non-randomized, prospectively documented series of 143 patients with histologically positive nodes in the neck or parotid was analyzed. There were 152 dissected necks or parotids: 45 of these received postoperative radiotherapy, 6 x 5.5 Gy fractions over 3 weeks; 107 were not irradiated. RESULTS The regional recurrence rate was 6.5% in the irradiated group, compared with 18.7% in the non-irradiated group (p = .055). The irradiated group, however, had more extensive nodal involvement than the non-irradiated group: 65% had two or more positive nodes, and 48% had extracapsular spread, compared with 40% and 19%, respectively, in the non-irradiated group. Survival was significantly worse when there was extracapsular spread (p < .05) or multiple node involvement (p < .01). By multivariate analysis, the use of adjuvant radiotherapy was associated with a trend toward improved regional control (p = .065), but survival was not improved. CONCLUSIONS Adjuvant radiotherapy was associated with improved control of metastatic malignant melanoma in the neck and parotid; however, statistical significance was not reached. A prospective trial should be supported to clarify this question.
C J O'Brien, and
K Petersen-Schaefer, and
G N Stevens, and
P C Bass, and
P Tew, and
V J Gebski, and
J F Thompson, and
W H McCarthy
December 1973,
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C J O'Brien, and
K Petersen-Schaefer, and
G N Stevens, and
P C Bass, and
P Tew, and
V J Gebski, and
J F Thompson, and
W H McCarthy
January 1992,
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C J O'Brien, and
K Petersen-Schaefer, and
G N Stevens, and
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February 1990,
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C J O'Brien, and
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G N Stevens, and
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January 2013,
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C J O'Brien, and
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W H McCarthy
January 2000,
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August 2009,
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February 2020,
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C J O'Brien, and
K Petersen-Schaefer, and
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March 1980,
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C J O'Brien, and
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C J O'Brien, and
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January 2013,
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