ILIOINGUINAL BLOCK DISSECTION FOR MALIGNANT-MELANOMA

A retrospective analysis of 41 patients treated for metastatic inguina l lymph node malignant melanoma is presented: 16 underwent inguinal no de excision and 25 ilioinguinal node excision. The two groups were wel l matched for age, sex and other characteristics. The mean time in hos pital (inguinal 20 days, ilioinguinal 18 days) and the complication ra tes (inguinal, ten of 16 patients, ilioinguinal, 13 of 25) were simila r in each group. The incidence of groin relapse, defined as the develo pment of symptomatic melanoma in the region of the inguinal or iliac n ode basins following block dissection, was lower after ilioinguinal bl ock dissection (inguinal, three patients; ilioinguinal, none). Histolo gical examination demonstrated a high proportion of iliac node involve ment (13 of 25 patients), even in those with a single mobile inguinal lymph node clinically and no clinical or computed tomographic evidence of iliac node involvement. This supports the value of ilioinguinal bl ock dissection and suggests that the associated morbidity need not be greater than that associated with inguinal clearance alone.