ELECTIVE LYMPH-NODE DISSECTION IN PRIMARY MALIGNANT-MELANOMA

The role of elective lymph node dissection (ELND) in primary malignant melanoma is controversial. Our purpose was to evaluate the benefit of ELND regarding survival and disease-free survival in malignant melano ma of the trunk and extremities. By matched-pair analysis, 375 patient s treated by wide local excision (WLE) plus ELND were compared to 375 patients treated by WLE only. There was no difference in survival betw een the two treatment groups; however, the disease-free interval was s ignificantly higher in the collective treated by WLE plus ELND (P<0.05 ). Increased survival rates were noted for intermediate tumor thicknes s of 1.51-4.0 mm for the WLE + ELND group although the difference was not significant (P = 0.14), and disease-free survival was significantl y improved in this group (P<0.001). ELND elicited a higher benefit in male patients with intermediate thickness melanoma. Our results confir m the findings of several studies that ELND improves the outcome after primary treament of malignant melanoma of intermediate tumor thicknes s.