scholarly journals Appendicular neoplasms and consequences in patients undergoing surgery for suspected acute appendicitis

2020 ◽  
Vol 35 (11) ◽  
pp. 2065-2071
Author(s):  
M. D. M. Bolmers ◽  
◽  
J. de Jonge ◽  
C. C. van Rossem ◽  
A. A. W. van Geloven ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Primary Outcome ◽  
Independent Predictor ◽  
Multivariable Analysis ◽  
Postoperative Management ◽  
Histological Evaluation ◽  
Malignant Neoplasms ◽  
Observational Cohort ◽  
Suspected Acute Appendicitis

Abstract Introduction In patients treated with an appendectomy for acute appendicitis, the specimen is generally sent for histological evaluation. In an era of increasing non-operative treatment for acute appendicitis, it is important to know the incidence, the diagnostic accuracy, and treatment consequences of appendicular neoplasms that are found in acute appendicitis. We hypothesize that pre- and intra-operative parameters might predict an appendicular neoplasm. Methods Data was used from our previous prospective observational cohort study. All patients undergoing surgery for suspected acute appendicitis were included. The primary outcome was the incidence of appendicular neoplasms in patients operated for acute appendicitis. Secondary outcomes were pre-operative diagnostics and imaging outcomes, intra-operative surgical judgment, and postoperative management and outcome. Possible predictors of an appendicular neoplasm were identified and used in multivariable logistic regression. Patients with an appendicular neoplasm were followed for 3 years after initial appendectomy. Results A total of 1975 patients underwent surgery for suspected acute appendicitis and in 98.3% (1941/1975) the appendix was removed. In 1.5% (30/1941) of these patients, an appendicular neoplasm was found. Among the malignant neoplasms, the majority were grade 1 neuroendocrine tumors (NET) in 65% (13/20). On pre-operative imaging, there was no suspicion of malignancy. In three cases, there was an intra-operative suspicion of malignancy. Multivariable analysis showed only age as an independent predictor for appendicular neoplasms. No recurrent or new malignancy was found during follow-up. Discussion The incidence of appendicular neoplasm in patients undergoing an acute appendectomy is very low and clinical risk factors could not be identified.

Abstract 17492: Extent and Pattern of Late Gadolinium Enhancement Predict Arrhythmic Events in Patients With Nonischemic Dilated Cardiomyopathy

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Dong Geum Shin ◽  
Hye-Jeong Lee ◽  
Junbeom Park ◽  
Young Jin Kim ◽  
Jae-Sun Uhm ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Ventricular Arrhythmia ◽  
Dilated Cardiomyopathy ◽  
Cardiac Death ◽  
Primary Outcome ◽  
Multivariable Analysis ◽  
Gadolinium Enhancement ◽  
Nonischemic Dilated Cardiomyopathy ◽  
The Impact

Background: Late gadolinium enhancement (LGE) by cardiac MR (CMR) has been related to adverse clinical outcomes in patients with nonischemic dilated cardiomyopathy (NIDC). But, a statistically significant association between LGE and arrhythmic risk in NIDC has not been demonstrated consistently. This study evaluated the impact of the presence, location and pattern of LGE on arrhythmic risk prediction in NICM. Methods: This study included 365 patients (54±15years) with NICM who underwent CMR. The extent, location and pattern of LGE were categorized. We analyzed for the primary outcome of ventricular arrhythmia (VA) including sustained or nonsustained ventricular tachycardia (VT), appropriate implantable cardioverter-defibrillator (ICD) intervention and ventricular fibrillation (VF). Cardiac death and hospitalization for heart failure (HF) were evaluated as secondary outcomes. Results: LGE was seen in 267 (73 %) patients. During median follow-up of 44±36 months, patients with LGE had higher incidence of cardiac death (15 % vs. 2 %, p<0.001), hospitalization for HF (40 % vs. 15 %, p<0.001) and VA (14% vs. 6%, p=0.03). In multivariable analysis, the presence of LGE (HR 2.78; 95% CI 1.10-7.02; p=0.03) was the independent predictor of arrhythmias. Patients with extensive LGE had higher VA (32% vs. 10%, p<0.001) with lower cumulative survival free of VA than those without extensive LGE (p=0.001). The frequent LGE location was as follows: LV septum 64%, LV-RV junction 42% and inferior 10%. VA was lower in patients with than without localized LGE limited to LV-RV junction (21% vs. 46%, p=0.005). Interestingly, while the incidence of ventricular arrhythmia was higher in patients with transmural LGE (29% vs. 10%, p=0.003), it was lower in those with patch LGE (2% vs. 16%, p=0.02) than the other patients. Conclusions: In patients with NICM, the LGE was an independent prognostic predictor of VA. Extensive LGE and specific location of LGE was related with the arrhythmic events.

scholarly journals Isolated Crohn’s Disease of the Appendix Presenting as Acute Appendicitis in a 60-Year-Old South Asian Female: A Case Report, Review of Literature, and Follow-Up Recommendations

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Pamathy Gnanaselvam ◽  
Dhanushka N. Weerakoon ◽  
W. A. M. Wijayasuriya ◽  
Vishva Samidi Mohottala ◽  
B. M. E. S. Sinhakumara ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Case Report ◽  
Crohn's Disease ◽  
Acute Appendicitis ◽  
Clinical Findings ◽  
Additional Treatment ◽  
Histological Evaluation ◽  
Histopathological Analysis ◽  
Review Of Literature

The isolated appendiceal Crohn’s disease without preceding bowel symptoms is a rare phenomenon, especially in older patients. In this case report, we present a 60-year-old female with isolated appendiceal Crohn’s disease presenting with acute appendicitis. She presented with classical features of appendicitis with elevated inflammatory markers. She underwent an appendectomy which showed an excessively swollen, oedematous, and reddish appendix with swelling extending to the base of the caecum. Histological evaluation was suggestive of Crohn’s disease, and subsequent colonoscopy was unremarkable. Following appendectomy, she was asymptomatic without any recurrence of disease. The atypical morphological appearance of the appendix should raise suspicion of Crohn’s disease. This case highlights the importance of histopathological analysis of the specimen, especially in abnormal clinical findings. The prognosis of such patients seems to be good, and additional treatment is rarely needed.

4070Clinical impact of mitral regurgitation before or following transcatheter aortic valve replacement in patients with aortic stenosis: a nationwide multivariable analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Fauchier ◽  
A Bernard ◽  
A Bisson ◽  
T Lacour ◽  
J Herbert ◽  
...  
Keyword(s):  
Transcatheter Aortic Valve Replacement ◽  
Independent Predictor ◽  
Multivariable Analysis ◽  
Total Mortality ◽  
Transcatheter Aortic Valve ◽  
Mortality Hazard ◽  
History Of ◽  
The Impact ◽  
Mortality Hazard Ratio

Abstract Patients undergoing transcatheter aortic valve replacement (TAVR) may have concomitant mitral regurgitation (MR). The impact of MR at baseline or after TAVR on subsequent prognosis remains to be more precisely determined. We analysed the impact of MR before or after TAVR on prognosis in the systematic analysis of patients treated with TAVR at a nationwide level. Methods Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients with aortic stenosis treated with transfemoral TAVR in France between 2008 and 2018. Cox regression was used for the analysis of predictors of events during follow-up. Results A total of 47,872 patients with transfemoral TAVR were included in the analysis (mean age 83±7 years). Moderate/severe MR was present at baseline (MRb) in 9.5% of the patients. Few patients (1.6%) revealed moderate/severe MR post-TAVR (MRpt). Mean follow-up was 1.31±1.61 years. MRb was associated with an increased cardiovascular mortality (Hazard ratio 1.29, 95% CI 1.20–1.39) and total mortality (Hazard ratio 1.15, 95% CI 1.10–1.21). However, MRb was not an independent predictor in multivariable analysis, neither for cardiovascular mortality (adjusted HR 1.06, 95% CI 0.98–1.14) nor for total mortality (adjusted HR 1.01, 95% CI 0.96–1.07). MRpt was not a predictor of cardiovascular or total mortality. Older age, male sex, history of pulmonary edema/cardiogenic shock, atrial fibrillation, myocardial infarction, diabetes, renal failure, liver disease, pulmonary disease, previous cancer and anemia at baseline independently predicted mortality during follow-up. All of them (but history of cancer) were also independent predictor of cardiovascular death. Conclusion Baseline MR was associated with increased cardiovascular and totality mortality following TAVR but was not an independent predictor of any of them. By contrast, several other predictors of cardiovascular and total mortality were identified. This suggests that MR should not be directly considered to establish the strategy for TAVR decision or for avoiding TAVR-related futility.

scholarly journals P305 Effectiveness and Safety of Vedolizumab in Biologic-Naïve Patients: Real-World Data from the Sicilian Network for Inflammatory Bowel Diseases (SN-IBD)

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S333-S333
Author(s):  
F Macaluso ◽  
W Fries ◽  
S Renna ◽  
A Viola ◽  
M Muscianisi ◽  
...  
Keyword(s):  
Clinical Response ◽  
Real World ◽  
Primary Outcome ◽  
Real World Data ◽  
Mayo Score ◽  
Significant Difference ◽  
Bowel Diseases ◽  
Observational Cohort ◽  
Inflammatory Bowel

Abstract Background Biologic-naïve patients treated with Vedolizumab (VDZ) are largely underrepresented in real-world cohorts. We performed a multicentre, observational, cohort study on the effectiveness and safety of VDZ as treatment for Crohn’s disease (CD) and ulcerative colitis (UC) among biologic-naïve subjects. Methods Data of consecutive biologic-naïve patients with CD and UC treated with VDZ from July 2016 to December 2019 were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Disease (SN-IBD). The primary outcome was the clinical response at 14 and 52 weeks evaluated with Harvey Bradshaw Index in CD and partial Mayo score in UC. Results 172 consecutive patients (CD: n=88; UC: n=84; median age 66.0 years) were included, with a median follow-up of 58.8 weeks. After 14 weeks, a clinical response was reported in 68.2% of patients with CD and 67.9% of patients with UC treated with VDZ, including 45.5% patients in the CD group and 46.4% patients in the UC group who achieved steroid-free remission. After 52 weeks, a clinical response was reported in 77.4% of CD and in 73.8% of UC patients treated with VDZ, including 59.7% patients in the CD group and 60.7% patients in the UC group who achieved steroid-free remission. All differences between CD and UC were not statistically significant. Cox survival analysis showed no significant difference in the probability of treatment discontinuation between CD and UC patients (log-rank p=0.73). Conclusion This large, real-world, multicenter study demonstrated the effectiveness and safety of VDZ as a first-line biologic, showing high rates of clinical response and steroid-free remission at both induction and maintenance.

scholarly journals Accelerated hyper-versus normofractionated radiochemotherapy with temozolomide in patients with glioblastoma: a multicenter retrospective analysis

2021 ◽  
Author(s):  
Rainer J. Klement ◽  
Ilinca Popp ◽  
David Kaul ◽  
Felix Ehret ◽  
Anca L. Grosu ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Standard Treatment ◽  
Treatment Time ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Target Volume ◽  
Hyperfractionated Radiotherapy ◽  
Adjuvant Temozolomide ◽  
Multicenter Analysis

Abstract Background and purpose The standard treatment of glioblastoma patients consists of surgery followed by normofractionated radiotherapy (NFRT) with concomitant and adjuvant temozolomide chemotherapy. Whether accelerated hyperfractionated radiotherapy (HFRT) yields comparable results to NFRT in combination with temozolomide has only sparsely been investigated. The objective of this study was to compare NFRT with HFRT in a multicenter analysis. Materials and methods A total of 484 glioblastoma patients from four centers were retrospectively pooled and analyzed. Three-hundred-ten and 174 patients had been treated with NFRT (30 × 1.8 Gy or 30 × 2 Gy) and HFRT (37 × 1.6 Gy or 30 × 1.8 Gy twice/day), respectively. The primary outcome of interest was overall survival (OS) which was correlated with patient-, tumor- and treatment-related variables via univariable and multivariable Cox frailty models. For multivariable modeling, missing covariates were imputed using multiple imputation by chained equations, and a sensitivity analysis was performed on the complete-cases-only dataset. Results After a median follow-up of 15.7 months (range 0.8–88.6 months), median OS was 16.9 months (15.0–18.7 months) in the NFRT group and 14.9 months (13.2–17.3 months) in the HFRT group (p = 0.26). In multivariable frailty regression, better performance status, gross-total versus not gross-total resection, MGMT hypermethylation, IDH mutation, smaller planning target volume and salvage therapy were significantly associated with longer OS (all p < 0.01). Treatment differences (HFRT versus NFRT) had no significant effect on OS in either univariable or multivariable analysis. Conclusions Since HFRT with temozolomide was not associated with worse OS, we assume HFRT to be a potential option for patients wishing to shorten their treatment time.

scholarly journals Unsupervised Clustering Identifies Sub-Phenotypes and Reveals Pre-Dialysis Hyperlactatemia as a Novel Outcome Predictor in Dialysis-Requiring Sepsis-Associated Acute Kidney Injury

2021 ◽  
Author(s):  
Chun-Fu Lai ◽  
Vin-Cent Wu ◽  
Jung-Hua Liu ◽  
Shuei-Liong Lin ◽  
Yung-Ming Chen
Keyword(s):  
Acute Kidney Injury ◽  
Clustering Analysis ◽  
Independent Predictor ◽  
Kidney Injury ◽  
Consensus Clustering ◽  
Risk Modeling ◽  
Outcome Predictor ◽  
All Cause Mortality ◽  
Observational Cohort

Abstract BackgroundHeterogeneity exists in sepsis-associated acute kidney injury (SA-AKI). This prospective observational cohort study aimed to perform consensus cluster analysis and investigate the clinical relevance of identified sub-phenotypes of critically ill patients with dialysis-requiring SA-AKI.MethodsAll septic patients with dialysis-requiring SA-AKI, defined by the Sepsis-3 and Kidney Disease: Improving Global Outcomes AKI criteria, admitted to an intensive care unit in Taiwan between 2002 and 2018 were included. We employed unsupervised consensus clustering based on 22 clinical variables upon initialising renal replacement therapy. They were observed until death or 90 days after hospital discharge. The outcomes were mortality and being free of dialysis.ResultsIn total, 1,397 patients were enrolled (mean age of 63.8 ± 16.38 years and 69.7% were men). After a median follow-up period of 31 (interquartile range 8-123) days, all-cause mortality occurred in 911 patients (65.12%). Moreover, 133 (9.51%) survivors were dialysis dependent, where 355 (25.38%) survivors were free of dialysis. Unsupervised consensus clustering identified three sub-phenotypes associated with significantly different risks of mortality and being free of dialysis. This strategy led us to reveal that the pre-dialysis hyperlactatemia of ≥ 3.1 mmol/L was an independent predictor of mortality and being free of dialysis according to the competing risk modeling. Our results were validated in an independent multi-center AKI cohort.ConclusionsBy the data-driven clustering analysis, we identified sub-phenotypes in septic patients with dialysis-requiring SA-AKI and revealed pre-dialysis hyperlactatemia as a novel outcome predictor. This result represents a step towards precision medicine for septic patients.

scholarly journals Infections after pediatric ambulatory surgery: Incidence and risk factors

2019 ◽  
Vol 40 (2) ◽  
pp. 150-157 ◽  
Author(s):  
Jeffrey S. Gerber ◽  
Rachael K. Ross ◽  
Julia E. Szymczak ◽  
Rui Xiao ◽  
A. Russell Localio ◽  
...  
Keyword(s):  
Ambulatory Surgery ◽  
Multivariable Analysis ◽  
Surgical Site Infections ◽  
Patient Demographics ◽  
Additional Burden ◽  
Observational Cohort ◽  
Parental Interviews ◽  
Pediatric Healthcare ◽  
Surgery Incidence

AbstractObjectiveTo describe the epidemiology of surgical site infections (SSIs) after pediatric ambulatory surgery.DesignObservational cohort study with 60 days follow-up after surgery.SettingThe study took place in 3 ambulatory surgical facilities (ASFs) and 1 hospital-based facility in a single pediatric healthcare network.ParticipantsChildren <18 years undergoing ambulatory surgery were included in the study. Of 19,777 eligible surgical encounters, 8,502 patients were enrolled.MethodsData were collected through parental interviews and from chart reviews. We assessed 2 outcomes: (1) National Healthcare Safety Network (NHSN)–defined SSI and (2) evidence of possible infection using a definition developed for this study.ResultsWe identified 21 NSHN SSIs for a rate of 2.5 SSIs per 1,000 surgical encounters: 2.9 per 1,000 at the hospital-based facility and 1.6 per 1,000 at the ASFs. After restricting the search to procedures completed at both facilities and adjustment for patient demographics, there was no difference in the risk of NHSN SSI between the 2 types of facilities (odds ratio, 0.7; 95% confidence interval, 0.2–2.3). Within 60 days after surgery, 404 surgical patients had some or strong evidence of possible infection obtained from parental interview and/or chart review (rate, 48 SSIs per 1,000 surgical encounters). Of 306 cases identified through parental interviews, 176 cases (57%) did not have chart documentation. In our multivariable analysis, older age and black race were associated with a reduced risk of possible infection.ConclusionsThe rate of NHSN-defined SSI after pediatric ambulatory surgery was low, although a substantial additional burden of infectious morbidity related to surgery might not have been captured by standard surveillance strategies and definitions.

scholarly journals The improvement of QRS-T angle as a manifestation of reverse electrical remodeling following renal transplantation in end-stage kidney disease patients on haemodialysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrzej Jaroszyński ◽  
Jacek Furmaga ◽  
Tomasz Zapolski ◽  
Tomasz Zaborowski ◽  
Sławomir Rudzki ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Left Ventricle ◽  
Ventricular Remodeling ◽  
Independent Predictor ◽  
Contractile Function ◽  
Strong Predictor ◽  
Multivariable Analysis ◽  
Electrical Remodeling ◽  
Echocardiographic Parameters

Abstract Background Successful renal transplantation (RT) reverses some of the cardiac changes and reduces cardiac mortality in hemodialysis (HD) patients. Widened QRS-T angle reflects both ventricular repolarization and depolarization. It is considered a sensitive and strong predictor of heart ventricular remodeling as well as a powerful and independent risk stratifier suitable in predicting cardiac events in various clinical settings. The study aimed to assess the influence of the RT on QRS-T angle and to evaluate factors influencing QRS-T changes in renal transplanted recipients (RTRs). Methods Fifty-four selected HD patients who have undergone RT were included. Blood chemistry, echocardiography, and QRS-T angle were evaluated 5 times: about 1 week, 3 months, 6 months, 1 year and 3 years after RT. Results An improvement of echocardiographic parameters was observed. The dynamics of changes in individual parameters were, however, variable. QRS-T angle correlated with echocardiographic parameters. The biphasic pattern of the decreases of QRS-T angle was observed. The first decrease took place in the third month of follow-up. The second decrease of QRS-T angle was observed after 1 year of follow-up. The QRS-T angle was higher in RTRs compared with controls during each evaluation. Multivariable analysis demonstrated that the decrease of left ventricle enddiastolic volume was an independent predictor of early QRS-T angle improvement. The increase of left ventricle ejection fraction was found to be the independent predictor of the late QRS-T angle improvement. Conclusions RT induces biphasic reverse electrical remodeling as assessed by the narrowing of QRS-T angle. Early decrease of QRS-T angle is mainly due to the normalization of volume status, whereas late decrease is associated predominantly with the improvement of cardiac contractile function.

Multicenter comparison of outcomes for clinical and pathologic T3a renal cell carcinoma.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 758-758
Author(s):  
Aaron Bradshaw ◽  
Fady Ghali ◽  
Nathan Miller ◽  
Cathrine Keiner ◽  
Raksha Dutt ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Primary Outcome ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Rank Test ◽  
Similar Proportion ◽  
Secondary Outcomes

758 Background: The identification of venous thrombus in patients with renal cell carcinoma (RCC) is particularly challenging, with a substantial number upstaged to pathologic T3a following intervention. We compared survival outcomes between patients with initial cT3a status versus those upstaged to pT3a. Methods: This is a retrospective, multicenter analysis of patients with cT3a or pT3a RCC who underwent operative management. Primary outcome was recurrence-free survival (RFS). Secondary outcomes were overall survival (OS) and cancer-specific survival (CSS). Cox regression multivariable analysis (MVA) was utilized for primary outcome. Kaplan-Meier analyses (KMA) were conducted to describe RFS, OS, and CSS with log-rank test comparing clinical and upstaged pathologic T3a groups. Results: 770 patients were analyzed (cT3a 184, pT3a 586, median follow-up 28 months). Average pathologic tumor size was smaller in pT3a (7.2 cm vs 8.7 cm, p < 0.01), with no significant differences in clinical variables. A similar proportion underwent radical nephrectomy (vs. partial) (89.7% cT3a and 85.0% pT3a, p = 0.11) with no significant different in positive margin rate (3.8% cT3a, 4.8% pT3a, p = 0.23). However, a higher proportion of patients with cT3a disease were pathologically node positive (19.0% vs. 10.8%, p < 0.01) and demonstrated a higher rate of recurrence (cT3a 51.1% vs. pT3a 34.1%, p < 0.01) despite shorter mean follow-up (cT3a 33.0 vs. pT3a 50.7 mo, p < 0.01). MVA for RFS revealed cT3a staging (pT3a referent, HR 1.72, p < 0.01), positive margins (HR 2.85, p < 0.01), and clear cell histology (HR 1.68, p < 0.01) to be independently associated with higher recurrence rate, while partial nephrectomy (radical referent, HR 0.259, p < 0.01) was associated with a decreased rate. KMA revealed 5-year RFS of 34.4% and 60.6% for cT3a and pT3a respectively (p < 0.01). KMA for secondary outcomes revealed 5-year OS rates of 56.7% and 62.0% (p = 0.02) and 5-year CSS of 74.4% and 67.7% for cT3a and pT3a respectively (p = 0.01). Conclusions: Patients with cT3a RCC have poorer oncologic outcomes than those with upstaged pT3a RCC. Suspected venous involvement on pre-operative imaging may indicate more aggressive or advanced disease than that found during surgery.

Adjuvant Radiation Does Not Affect Locoregional Control Following Resection of Melanoma Satellitosis or In-Transit Disease

2021 ◽  
pp. 000313482110474
Author(s):  
Alexander C. Yaney ◽  
Kara K. Rossfeld ◽  
Trudy C. Wu ◽  
Doreen M. Agnese ◽  
Alicia M. Terando ◽  
...  
Keyword(s):  
Locoregional Recurrence ◽  
Independent Predictor ◽  
Multivariable Analysis ◽  
Positive Margin ◽  
Locoregional Control ◽  
Adjuvant Radiation ◽  
Related Factor ◽  
Adjuvant Radiation Therapy ◽  
In Transit

Background This study evaluates the association of adjuvant radiation therapy (RT) with improved locoregional (LR) recurrence for resected melanoma satellitosis and in-transit disease (ITD). Materials and Methods Data were collected retrospectively for resected melanoma satellitosis/ITD from 1996 to 2017. Results 99 patients were identified. 20 patients (20.2%) received adjuvant RT while 79 (79.8%) did not. Mean follow-up in the RT group was 4.3 years and 4.7 years in the non-RT group. 80% of patients who underwent RT suffered a complication, most commonly dermatitis. Locoregional recurrence occurred in 9 patients (45%) treated with adjuvant RT and 30 patients (38%) in the non-RT group ( P = 0.805). Median LR-DFS was 5.8 years in the RT group and 9.5 years in the non-RT group ( P = 0.604). On multivariable analysis, having a close or positive margin was the only independent predictor of LR-DFS (HR 3.8 95% CI 1.7-8.7). In-transit disease was associated with improved overall survival when compared to satellitosis (HR 0.260, 95% CI 0.08-0.82). Discussion The use of adjuvant RT is not associated with improved locoregional control in resected melanoma satellitosis or ITD. Close or positive margin was the only treatment-related factor associated with decreased LR-DFS after surgical resection of satellitosis/ITD.

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