Recurrence patterns and outcome in 1019 patients undergoing axillary or inguinal lymphadenectomy for melanoma
M. A. Gadd and D. G. Coit
Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Patterns of recurrence and outcome were determined in 403 patients with
melanoma who underwent an axillary or inguinal lymphadenectomy. Recurrences
developed at single sites in 291 (72%) patients, with a median survival of
11 months, and at multiple sites in 112 (28%) patients, with a median
survival of 3 months. Among patients with single-site recurrence, those
with nonvisceral recurrence (n = 190) had a median survival of 18.5 months
compared with 6 months in those with visceral recurrence (n = 101).
Recurrences were treated surgically in 240 (60%) patients, with a median
survival of 15 months, and nonsurgically in 112 patients, with a median
survival of 4 months. Median survival after complete resection of
single-site recurrence was 19 months compared with 6 months after
incomplete resection. Multivariate analysis revealed that outcome was
improved by surgical treatment, single-site and nonvisceral recurrence, and
primary site in an extremity. These observations support an approach of
selective resection in the treatment of recurrences after lymphadenectomy.
