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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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Swaminathan Murugappan, William P. Harris, Christopher G. Willett, and Edward Lin

the local recurrence rate of LARC. The goal of this surgery is the en bloc resection of the rectal cancer with a complete pararectal lymph node dissection within the mesorectum. Meticulous sharp dissection and avoidance of disruption of the mesorectum

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Peter E. Clark, Philippe E. Spiess, Neeraj Agarwal, Rick Bangs, Stephen A. Boorjian, Mark K. Buyyounouski, Jason A. Efstathiou, Thomas W. Flaig, Terence Friedlander, Richard E. Greenberg, Khurshid A. Guru, Noah Hahn, Harry W. Herr, Christopher Hoimes, Brant A. Inman, A. Karim Kader, Adam S. Kibel, Timothy M. Kuzel, Subodh M. Lele, Joshua J. Meeks, Jeff Michalski, Jeffrey S. Montgomery, Lance C. Pagliaro, Sumanta K. Pal, Anthony Patterson, Daniel Petrylak, Elizabeth R. Plimack, Kamal S. Pohar, Michael P. Porter, Wade J. Sexton, Arlene O. Siefker-Radtke, Guru Sonpavde, Jonathan Tward, Geoffrey Wile, Mary A. Dwyer, and Courtney Smith

tumor staging and N0 or N1 muscle-invasive bladder cancer (n=44) were given 3 cycles of ddMVAC with pegfilgrastim followed by radical cystectomy and lymph node dissection. 36 ddMVAC was anticipated to have a safer profile, a shorter time to surgery, and

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Elizabeth R. Kessler, Janet B. Kukreja, Christopher L. Geiger, and Stacy M. Fischer

chemotherapy (NAC) followed by radical cystectomy (RC) and an extended lymph node dissection. In addition, trimodality therapy (TMT) including maximal transurethral resection of bladder tumor (TURBT) followed by combined chemotherapy and radiotherapy (RT) may

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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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Noam VanderWalde, Reshma Jagsi, Efrat Dotan, Joel Baumgartner, Ilene S. Browner, Peggy Burhenn, Harvey Jay Cohen, Barish H. Edil, Beatrice Edwards, Martine Extermann, Apar Kishor P. Ganti, Cary Gross, Joleen Hubbard, Nancy L. Keating, Beatriz Korc-Grodzicki, June M. McKoy, Bruno C. Medeiros, Ewa Mrozek, Tracey O'Connor, Hope S. Rugo, Randall W. Rupper, Dale Shepard, Rebecca A. Silliman, Derek L. Stirewalt, William P. Tew, Louise C. Walter, Tanya Wildes, Mary Anne Bergman, Hema Sundar, and Arti Hurria

. Treatment toxicity can be minimized by careful patient selection, appropriate radiation dose, and optimized dosimetry to meet normal tissue constraints. Lung Cancers Non–Small Cell Lung Cancer Surgical resection and mediastinal 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

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Peter E. Clark, Neeraj Agarwal, Matthew C. Biagioli, Mario A. Eisenberger, Richard E. Greenberg, Harry W. Herr, Brant A. Inman, Deborah A. Kuban, Timothy M. Kuzel, Subodh M. Lele, Jeff Michalski, Lance C. Pagliaro, Sumanta K. Pal, Anthony Patterson, Elizabeth R. Plimack, Kamal S. Pohar, Michael P. Porter, Jerome P. Richie, Wade J. Sexton, William U. Shipley, Eric J. Small, Philippe E. Spiess, Donald L. Trump, Geoffrey Wile, Timothy G. Wilson, Mary Dwyer, and Maria Ho

” before the stage refers to clinical staging based on bimanual EUA and endoscopic surgery (biopsy or TUR) and imaging studies. A modifier “p” would refer to pathologic staging based on cystectomy and lymph node dissection. A second TUR is performed when

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Daniel G. Coit, John A. Thompson, Alain Algazi, Robert Andtbacka, Christopher K. Bichakjian, William E. Carson III, Gregory A. Daniels, Dominick DiMaio, Marc Ernstoff, Ryan C. Fields, Martin D. Fleming, Rene Gonzalez, Valerie Guild, Allan C. Halpern, F. Stephen Hodi Jr, Richard W. Joseph, Julie R. Lange, Mary C. Martini, Miguel A. Materin, Anthony J. Olszanski, Merrick I. Ross, April K. Salama, Joseph Skitzki, Jeff Sosman, Susan M. Swetter, Kenneth K. Tanabe, Javier F. Torres-Roca, Vijay Trisal, Marshall M. Urist, Nicole McMillian, and Anita Engh

lymph node dissection (CLND) was required for ipilimumab treatment in the trial; however, it is not clear that patients opting out of CLND should necessarily be excluded from consideration for this option, as ipilimumab has demonstrated efficacy in

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Deborah K. Armstrong, Ronald D. Alvarez, Jamie N. Bakkum-Gamez, Lisa Barroilhet, Kian Behbakht, Andrew Berchuck, Lee-may Chen, Mihaela Cristea, Maria DeRosa, Eric L. Eisenhauer, David M. Gershenson, Heidi J. Gray, Rachel Grisham, Ardeshir Hakam, Angela Jain, Amer Karam, Gottfried E. Konecny, Charles A. Leath III, Joyce Liu, Haider Mahdi, Lainie Martin, Daniela Matei, Michael McHale, Karen McLean, David S. Miller, David M. O’Malley, Sanja Percac-Lima, Elena Ratner, Steven W. Remmenga, Roberto Vargas, Theresa L. Werner, Emese Zsiros, Jennifer L. Burns, and Anita M. Engh

though PFS is not improved. 139 , 140 , 151 – 153 Pelvic and para-aortic lymph node dissection is recommended for patients with disease confined to affected ovaries or to the pelvis, and for those with more extensive disease who have tumor nodules outside