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William J. Gradishar, Benjamin O. Anderson, Ron Balassanian, Sarah L. Blair, Harold J. Burstein, Amy Cyr, Anthony D. Elias, William B. Farrar, Andres Forero, Sharon Hermes Giordano, Matthew Goetz, Lori J. Goldstein, Clifford A. Hudis, Steven J. Isakoff, P. Kelly Marcom, Ingrid A. Mayer, Beryl McCormick, Meena Moran, Sameer A. Patel, Lori J. Pierce, Elizabeth C. Reed, Kilian E. Salerno, Lee S. Schwartzberg, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, George Somlo, Melinda Telli, John H. Ward, Dorothy A. Shead, and Rashmi Kumar

II nodes, lymph node dissection should include tissue inferior to the axillary vein from the latissimus dorsi muscle laterally to the medial border of the pectoralis minor muscle (level I/II). Furthermore, according to the panel, without definitive

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David S. Ettinger, Mark Agulnik, Justin M. M. Cates, Mihaela Cristea, Crystal S. Denlinger, Keith D. Eaton, Panagiotis M. Fidias, David Gierada, Jon P. Gockerman, Charles R. Handorf, Renuka Iyer, Renato Lenzi, John Phay, Asif Rashid, Leonard Saltz, Lawrence N. Shulman, Jeffrey B. Smerage, Gauri R. Varadhachary, Jonathan S. Zager, and Weining (Ken) Zhen

used as a second- or third-line treatment. 85 Radiation Therapy Radiation therapy is a treatment option for a variety of localized tumors, particularly as follow-up treatment after lymph node dissection for the involvement of axillary or

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Wui-Jin Koh, Benjamin E. Greer, Nadeem R. Abu-Rustum, Susana M. Campos, Kathleen R. Cho, Hye Sook Chon, Christina Chu, David Cohn, Marta Ann Crispens, Don S. Dizon, Oliver Dorigo, Patricia J. Eifel, Christine M. Fisher, Peter Frederick, David K. Gaffney, Ernest Han, Susan Higgins, Warner K. Huh, John R. Lurain III, Andrea Mariani, David Mutch, Christa Nagel, Larissa Nekhlyudov, Amanda Nickles Fader, Steven W. Remmenga, R. Kevin Reynolds, Todd Tillmanns, Stefanie Ueda, Fidel A. Valea, Emily Wyse, Catheryn M. Yashar, Nicole McMillian, and Jillian Scavone

conservative primary tumor resection and regional lymph node management for early-stage disease. 43 The preferred surgical approach evolved towards vulvar conservation with separate incisions for lymph node dissection in patients who were clinically node

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Jaffer A. Ajani, Thomas A. D’Amico, David J. Bentrem, Joseph Chao, Carlos Corvera, Prajnan Das, Crystal S. Denlinger, Peter C. Enzinger, Paul Fanta, Farhood Farjah, Hans Gerdes, Michael Gibson, Robert E. Glasgow, James A. Hayman, Steven Hochwald, Wayne L. Hofstetter, David H. Ilson, Dawn Jaroszewski, Kimberly L. Johung, Rajesh N. Keswani, Lawrence R. Kleinberg, Stephen Leong, Quan P. Ly, Kristina A. Matkowskyj, Michael McNamara, Mary F. Mulcahy, Ravi K. Paluri, Haeseong Park, Kyle A. Perry, Jose Pimiento, George A. Poultsides, Robert Roses, Vivian E. Strong, Georgia Wiesner, Christopher G. Willett, Cameron D. Wright, Nicole R. McMillian, and Lenora A. Pluchino

considered for laparoscopic staging with peritoneal washings. Lymph node dissection (lymphadenectomy) can be performed using the standard or extended (en-bloc) technique. The number of lymph nodes removed has been shown to be an independent predictor of

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Robert I Haddad, Lindsay Bischoff, Douglas Ball, Victor Bernet, Erik Blomain, Naifa Lamki Busaidy, Michael Campbell, Paxton Dickson, Quan-Yang Duh, Hormoz Ehya, Whitney S. Goldner, Theresa Guo, Megan Haymart, Shelby Holt, Jason P. Hunt, Andrei Iagaru, Fouad Kandeel, Dominick M. Lamonica, Susan Mandel, Stephanie Markovina, Bryan McIver, Christopher D. Raeburn, Rod Rezaee, John A. Ridge, Mara Y. Roth, Randall P. Scheri, Jatin P. Shah, Jennifer A. Sipos, Rebecca Sippel, Cord Sturgeon, Thomas N. Wang, Lori J. Wirth, Richard J. Wong, Michael Yeh, Carly J. Cassara, and Susan Darlow

follicular thyroid carcinoma, except that (1) locoregional nodal metastases may be more common, and therefore therapeutic lymph node dissections of the affected compartment is needed for clinically apparent biopsy-proven disease; and (2) metastatic Hürthle

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Margaret A. Tempero, J. Pablo Arnoletti, Stephen Behrman, Edgar Ben-Josef, Al B. Benson III, Jordan D. Berlin, John L. Cameron, Ephraim S. Casper, Steven J. Cohen, Michelle Duff, Joshua D.I. Ellenhorn, William G. Hawkins, John P. Hoffman, Boris W. Kuvshinoff II, Mokenge P. Malafa, Peter Muscarella II, Eric K. Nakakura, Aaron R. Sasson, Sarah P. Thayer, Douglas S. Tyler, Robert S. Warren, Samuel Whiting, Christopher Willett, and Robert A. Wolff

advanced disease who did not undergo surgical treatment. 130 Thus, a few groups have recommended caution and only use vein resection for selected patients. Extended Lymphadenectomy The role of lymph node dissection as a component of

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David M. Brizel, William Lydiatt, and A. Dimitrios Colevas

radiotherapy with or without systemic therapy . Head Neck , in press . 76 Hehr T Classen J Schreck U . Selective lymph node dissection following hyperfractionated accelerated radio-(chemo-) therapy for advanced head and neck cancer . Strahlenther

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Melanoma, Version 2.2013

Featured Updates to the NCCN Guidelines

Daniel G. Coit, Robert Andtbacka, Christopher J. Anker, Christopher K. Bichakjian, William E. Carson III, Adil Daud, Dominick DiMaio, Martin D. Fleming, Valerie Guild, Allan C. Halpern, F. Stephen Hodi Jr., Mark C. Kelley, Nikhil I. Khushalani, Ragini R. Kudchadkar, Julie R. Lange, Anne Lind, Mary C. Martini, Anthony J. Olszanski, Scott K. Pruitt, Merrick I. Ross, Susan M. Swetter, Kenneth K. Tanabe, John A. Thompson, Vijay Trisal, Marshall M. Urist, Nicole McMillian, and Maria Ho

metastases who would be at higher risk of recurrence and who might be candidates for complete lymph node dissection or adjuvant systemic therapy. A large meta-analysis, including 71 studies and 25,240 participants, estimated the risk of nodal recurrence after

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Peter F. Coccia, Alberto S. Pappo, Jessica Altman, Smita Bhatia, Scott C. Borinstein, Joseph Flynn, A. Lindsay Frazier, Suzanne George, Robert Goldsby, Robert Hayashi, Mary S. Huang, Rebecca H. Johnson, Lynda Kwon Beaupin, Michael P. Link, Kevin C. Oeffinger, Kathleen M. Orr, Damon Reed, Holly L. Spraker, Deborah A. Thomas, Margaret von Mehren, Daniel S. Wechsler, Kimberly F. Whelan, Brad Zebrack, Dorothy A. Shead, and Hema Sundar

azoospermia. 6 Pelvic RT and cumulative cyclophosphamide doses greater than 9.5 g/m 2 are associated with a high risk of permanent infertility in men with non-Hodgkin’s lymphoma, Ewing sarcoma, and soft tissue sarcoma. 22 , 23 Retroperitoneal lymph node

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Scott V. Bratman, Kathleen C. Horst, Robert W. Carlson, and Daniel S. Kapp

mastectomy with axillary lymph node dissection. Pathologic evaluation revealed a 5.6-cm grade 3 infiltrating ductal carcinoma associated with ductal carcinoma in situ with both solid and cribriform types. Immunohistochemistry revealed strong positive staining