Clinical Outcomes of Isolated Regional Lymph Node Recurrence in Patients With Malignant Cutaneous Melanoma

Abstract Background: Cutaneous Melanoma (CM) is cancer with rising prevalence worldwide. The most significant predictor of CM is regional lymph node metastasis. Sentinel Lymph Node (SLN) biopsy has been used to stage CM and to identify lymphatic metastasis. This study aims to evaluate the SLN association with clinicopathological factors in the CM patients for a better surgical management. Methods: This retrospective study included 80 CM patients who had gone through lymphatic mapping and SLN biopsy at Imam Khomeini Hospital in Tehran from 2011 to 2018. The clinical and histologic factors, including sex, age, tumor location, Breslow thickness, ulceration, angiolymphatic invasion, tumor mitotic rate (TMR), and Clark level, were analyzed.Results: Fifty-six patients (70%) were found to have SLN, 19 patients (33.9%) were SLN-positive, and 37 patients (66.1%) were SLN-negative. Breslow thickness was the only variable that was significantly associated with the prediction of SLN. SLN was not correlated with other features such as ulceration, angiolymphatic invasion, and tumor mitotic rate. Complete Lymph Node Dissection (CLND) was carried out in 18 out of 19 SLN-positive patients. Moreover, 5 patients (27.8%) were found to be non-SLN-positive out of 18 SLN biopsy+CLND-positive patients. Furthermore, there was not any significant relationship between the clinicopathological features and the prediction of non-SLN. Conclusions: Breslow thickness was significantly correlated with positive SLN biopsy. Thus, it can be a strong predictor of positive SLN in CM patients.

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Analysis of Prognostic Factors and Clinical Outcomes in Isolated Paraaortic Lymph Node Recurrence of Uterine Cervical Carcinoma

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2018.07.1690 ◽

2018 ◽

Vol 102 (3) ◽

pp. e617-e618

Author(s):

C.S. Chen ◽

E.Y. Huang ◽

C.J. Wang

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Clinical Outcomes ◽

Cervical Carcinoma ◽

Paraaortic Lymph Node ◽

Uterine Cervical Carcinoma ◽

Lymph Node Recurrence

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Salvage treatment for lymph node recurrence after radical resection of esophageal squamous cell carcinoma

Radiation Oncology ◽

10.1186/s13014-019-1377-y ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Jie Chen ◽

Wenming Yin ◽

Hui Yao ◽

Wendong Gu

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Lymph Node ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Regional Lymph Node ◽

Radical Resection ◽

Salvage Treatment ◽

Lymph Node Recurrence

Abstract Background Patients with regional lymph node recurrence after radical resection of esophageal cancer have poor therapeutic outcomes. Currently, there is no standard treatment for regional lymph node recurrence, and its prognostic risk factors are not well-understood. This study retrospectively analyzed 83 patients with postoperative regional lymph node recurrence after radical resection of esophageal squamous cell carcinoma. The aim was to evaluate the clinical efficacy and prognostic factors of salvage radiotherapy with or without chemotherapy in these patients. Methods The survival and prognostic factors of 83 patients with esophageal squamous cell carcinoma with regional lymph node recurrence after radical surgery were retrospectively analyzed. All patients underwent radiotherapy, of which 74 patients received volumetric modulated arc therapy (VMAT), 9 patients received three-dimensional conformal radiation therapy (3DCRT), administered using a conventional segmentation protocol with a dose distribution range of 50.4–66.2Gy (median dose of 60Gy). In total, 41 patients received radiotherapy alone, 42 received radiotherapy combined with chemotherapy, and the concurrent chemotherapy regimen was mainly composed of either platinum or fluorouracil monotherapy, except for 4 patients who were given 5-fluorouracil plus platinum (FP) or paclitaxel plus platinum (TP). Results The median follow-up time was 24 (range, 9–75) months. The overall survival (OS) rates at 1 year, 2 years, 3 years, and 5 years were 83.0, 57.1, 40.1, and 35.1%, respectively. The median overall survival (OS) time was 18 (range, 5–75) months. The 3-year survival rate was 47.5% in patients with radiation alone and 41.9% in patients receiving concurrent chemoradiotherapy(p = 0.570), while the response rate (CR + PR) in those two groups was 73.2 and 91.4%, respectively. By multivariate analysis of OS, age (worse in younger patients, p = 0.034) was found to be significantly associated with disease prognosis. The commonly toxicities were esophagitis, neutropenia and anemia. 18% patients experienced grade 3 toxicity and no treatment-related death occurred. Conclusions These results of this retrospective analysis suggest that radiotherapy with or without chemotherapy is an effective and feasible salvage treatment for lymph node recurrence after radical resection of esophageal squamous cell carcinoma.

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