Adjuvant radiotherapy for cutaneous melanoma.

The purpose of the current study was to discuss the efficacy of adjuvant radiotherapy (RT) in the treatment of melanoma by reviewing the pertinent literature. The risk of locoregional recurrence after surgery alone for locally advanced melanoma is relatively high. The likelihood of a positive sentinel lymph node biopsy (SLNB) exceeds 20% for melanomas>2 mm thick and approximately>or=20% of those patients with positive SLNB will be found to have residual positive lymph nodes on completion lymph node dissection. Patients with positive regional lymph nodes have an approximately>or=20% risk of regional recurrence after surgery alone, particularly if multiple lymph nodes are involved and/or extracapsular extension is present. Postoperative adjuvant RT results in locoregional control rates of 85% to 90% or higher in high-risk patients with a modest risk of complications. The impact of adjuvant RT on survival is likely minimal.