Critical appraisal:Guadagnolo BA, Prieto V, Weber R, Ross MI, Zagars GK 2014

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Critical Appraisal

Article being appraised

Guadagnolo BA, Prieto V, Weber R, Ross MI, Zagars GK. The role of adjuvant radiotherapy in the local management of desmoplastic melanoma. Cancer 2014 May 1;120(9):1361-8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/24142803.


Applicable clinical question

Key Facts

Study Design

cohort study

Study aims:

To report on outcomes, specifically with respect to adjuvant radiotherapy, as well as prognostic factors for patients with desmoplastic melanoma.

Number of Patients:

130

surgery alone: 59
surgery plus postoperative radiotherapy: 71
Reported outcome(s):

overall survival
disease-specific survival
local control
distant metastatic recurrence
disease-free survival

Results of outcome(s):

Actuarial OS rates: 5y - 69%, 10y - 53%
disease-specific survival: 5y - 84%, 10y - 80%
disease-free survival: 5y - 69%, 10y - 70%

local recurrence - 24% vs 7%, surgery alone vs surgery plus postoperative radiotherapy

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

Risk of bias
High risk of bias Comments: new technology - discretion of surgeon

comparison - population presented for definitive local management at institution baseline not comparable, objective measures used, analysis for relevant factors (including intervention and sub-types) >95%

Risk of bias assessment: cohort study

Subject selection
"New technology" group
Highly selected or not described
Comparison group
Highly selected or not described
Comparability of groups on demographic characteristics and clinical features
Not comparable and not adjusted for differences
Measurement of outcomes
Outcome measures blind to technology used
No, but objective measures used
Same method of measurement used across comparison groups
Yes
Completeness of follow-up
Was follow-up complete and were all patients included in the analysis?
Yes (follow-up >95%) or survival analysis using all patients
Size of effect
5 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
1 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

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Completed by

Cecilia Taing


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Article
Guadagnolo BA, Prieto V, Weber R, Ross MI, Zagars GK. The role of adjuvant radiotherapy in the local management of desmoplastic melanoma. Cancer 2014 May 1;120(9):1361-8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/24142803.
Assigned to
User:Cecilia.taing
Topic area
Guidelines:Melanoma
Clinical question
Form
Form:Critical appraisal


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