title: Melanoma metastatic to cervical lymph nodes: Can radiotherapy replace formal dissection after local excision of nodal disease?
abstract: BACKGROUND
  Completion cervical lymphadenectomy is usually performed after excisional biopsy of nodal metastases from melanoma. Radiation (XRT) might be effective for some patients in lieu of formal lymph node dissection.
  
  
  METHODS
  Thirty-six patients with parotid or cervical node metastases from melanoma were treated with excision of nodal disease and postoperative XRT without formal lymph node dissection. Radiation was delivered to the primary site (if known), the site of nodal excision, and the undissected ipsilateral neck.
  
  
  RESULTS
  With a median follow-up of 5.3 years, the disease recurred within the regional basin in two patients and at distant sites in 14 patients. The actuarial 5-year regional control and distant metastasis-free survival rates were 93% and 59%, respectively. Two patients had a clinically significant side effect develop.
  
  
  CONCLUSIONS
  The results of this study suggest that selected patients may receive regional XRT after local excision of nodal disease from melanoma in lieu of formal lymph node dissection.
authors.affiliation: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. mballo@mdanderson.org
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Ballo
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Myers
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lee
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Diaz
authors.forename: Erich M
authors.initials: EM
authors.lastname: Sturgis
authors.forename: William H
authors.initials: WH
authors.lastname: Morrison
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Gershenwald
authors.forename: Merrick I
authors.initials: MI
authors.lastname: Ross
authors.forename: Randal S
authors.initials: RS
authors.lastname: Weber
authors.forename: K Kian
authors.initials: KK
authors.lastname: Ang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary; D008875:Middle Aged; D009333:Neck; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome