ArticleLangenbeck's archives of surgery2026
Therapy-refractory lymphatic fistulas following complete lymph node dissection in malignant melanoma: local radiotherapy as an effective therapeutic modality to avoid cancer treatment delay.
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Radiotherapy for postoperative groin lymphatic fistulas: A systematic review of clinical outcomes and treatment planning.Clinical and translational radiation oncology · 2026Review
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeComplete lymph node dissection (CLND) for stage III malignant melanoma is associated with substantial morbidity, particularly lymphatic fistulas (LF), which may delay adjuvant therapy. Grade C LF, characterized by prolonged secretion and clinical complications, lacks a standardized treatment algorithm. This study evaluated the efficacy and safety of radiotherapy in managing Grade C LF after axillary or inguinal CLND in malignant melanoma. MATERIALS AND
methodsWe conducted a retrospective, single-center study of patients with stage III malignant melanoma who developed Grade C LF after axillary or inguinal CLND between 2013 and 2021 at the University Hospital Bonn. Radiotherapy was administered as either low-dose or high-dose protocols. Treatment success was defined as LF resolution within 30 days post-radiation. Toxicities were assessed using RTOG and RTOG/EORTC scores.
resultsAmong 352 CLND procedures, 32 patients (9.1%) developed Grade C LF. Radiotherapy achieved resolution in 84.4% (27/32) of cases, independent site (inguinal vs. axillary, p = 0.999), laterality (p = 1.000), or timing of radiation initiation (p = 0.518). Low- and high-dose protocols achieved comparable success rates (89.5% vs. 76.9%, p = 0.347). However, high-dose radiotherapy caused significantly more acute (46.2% vs. 10.5%, p = 0.038) and long-term toxicities (38.5% vs. 5.3%, p = 0.029). Mean time to therapy success was 27 days after radiation initiation and 64 days after surgery, supporting adherence to the ESMO’s 12 week adjuvant window.
conclusionGrade C LF occurs in approximately 10% of patients following CLND and can delay adjuvant therapy. Radiotherapy, particularly low-dose protocols, is a safe and effective strategy to resolve LF and minimize treatment delays.
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