Should adjuvant radiotherapy be recommended following resection of regional lymph node metastases of malignant melanomas?

Background Several authors have recommended adjuvant radiotherapy following resection of regional lymph node metastases in cutaneous malignant melanom a. There is, however, little evidence from controlled trials that patients benefit from this treatment. Objectives To evaluate the usefulness of adjuvant radiotherapy following re section of lymph node metastases in cutaneous malignant melanoma. Methods We performed a retrospective study comparing 58 patients who underw ent radiotherapy following resection of regional lymph node metastases with 58 controls from another centre who exclusively underwent regional lymphad enectomy. Patients and their controls were matched with respect to the numb er of tumour-bearing lymph nodes (1 vs. > 1) and to gender, although the pr oportion of thick tumours was greater in the irradiation group. Results The overall survival curves were almost identical in the two groups . There were nine disease recurrences in the study group and 12 in the cont rol group (not significant). Regional recurrences in the irradiated patient s were usually accompanied by metastases at other sites. Conclusions The present study does not support the recommendation of adjuva nt radiotherapy following resection of regional lymph node metastases in pa tients with malignant melanoma.