title: Postoperative radiotherapy in head and neck mucosal melanoma: a GETTEC study.
abstract: OBJECTIVE
  to report patterns of failure according to treatment modality, with an emphasis on the role of postoperative radiotherapy in patients with localized head and neck mucosal melanoma (HNMM) treated during a 28-year period in a multi-institutional setting.
  
  
  METHODS
  retrospective review.
  
  
  METHODS
  french medical institutions.
  
  
  METHODS
  a total of 160 patients with nonmetastatic HNMM treated from 1980 through 2008.
  
  
  METHODS
  treatment modality consisted of surgery alone (hereinafter, S group) (n = 82 patients) or with postoperative radiotherapy (hereinafter, SRT group) (n = 78). Patients and tumor characteristics were similar in the 2 groups. There was a nonsignificant trend (P = .11) for more locally advanced tumor stage (38.9%) in the SRT group compared with the S group (24.5%).
  
  
  RESULTS
  patients in the S group had an increased probability of locoregional recurrence as a first event (55.6%) compared with those in the SRT group (29.9%; P < .01). After adjusting for tumor stage (T1/T2 vs T3/T4), the subdistribution hazard ratio of locoregional relapse was 0.31, (95% confidence interval [CI], 0.15-0.61; P < .01).The rate of distant metastasis as a first event was significantly higher in the SRT group (40.6%) compared with the S group (19.9%; P = .01). Regardless of their treatment, patients who had a locoregional relapse during follow-up had an increased risk of subsequent distant metastasis (hazard ratio, 3.07; 95% CI, 1.65-5.67) and death (hazard ratio, 3.01; 95% CI, 1.91-4.78).
  
  
  CONCLUSIONS
  this large retrospective study suggests that postoperative radiotherapy improves the locoregional control of HNMM. The higher rate of distant metastasis was due to more advanced disease in the SRT group.
authors.affiliation: Department of Head and Neck Surgery, Claudius Regaud Institute, 20-24 rue du pont Saint Pierre, Toulouse 31052, France. adil.benlyazid@gmail.com
authors.forename: Adil
authors.initials: A
authors.lastname: Benlyazid
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.forename: Stephane
authors.initials: S
authors.lastname: Temam
authors.forename: Olivier
authors.initials: O
authors.lastname: Malard
authors.forename: Carmen
authors.initials: C
authors.lastname: Florescu
authors.forename: Olivier
authors.initials: O
authors.lastname: Choussy
authors.forename: Marc
authors.initials: M
authors.lastname: Makeieff
authors.forename: Gilles
authors.initials: G
authors.lastname: Poissonnet
authors.forename: Nicolas
authors.initials: N
authors.lastname: Penel
authors.forename: Christian
authors.initials: C
authors.lastname: Righini
authors.forename: Bruno
authors.initials: B
authors.lastname: Toussaint
authors.forename: Jean
authors.initials: J
authors.lastname: Lacau St Guily
authors.forename: Sebastien
authors.initials: S
authors.lastname: Vergez
authors.forename: Thomas
authors.initials: T
authors.lastname: Filleron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D009092:Mucous Membrane; D009362:Neoplasm Metastasis / Q000517:prevention & control / Q000532:radiotherapy; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control*; D011182:Postoperative Care / Q000379:methods*; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013997:Time Factors