Extent of lymph node dissection in melanoma of the trunk or lower extremity
D. G. Coit and M. F. Brennan
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York.
The extent of lymph node dissection necessary to optimize survival and
minimize local recurrence in patients with melanoma of the trunk or lower
extremity is not well defined. We reviewed the records of 420 patients
undergoing superficial or combined superficial and deep groin dissection
for melanoma. Prognosis depended on the extent of lymph node involvement
rather than the extent of surgery performed. Node-positive patients
undergoing elective lymph node dissection had an improved survival over
those undergoing therapeutic lymph node dissection. In no subgroup of
patients was more extensive lymphadenectomy associated with significant
improvement in survival or alteration in pattern of recurrence. Dissection
of the deep pelvic nodes in patients with melanoma appears to be of more
prognostic than therapeutic value.
