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Elective lymph node dissection in stage I malignant melanoma: a meta-analysis.

D W Hein¹, R L Moy

¹UCLA Division of Dermatology, VA Wadsworth West Los Angeles Medical Center.

Melanoma Research

|November 1, 1992

Summary

Elective lymph node dissection (ELND) offers no significant survival benefit for all stage I melanoma patients. However, ELND significantly improves 5-year survival for intermediate thickness melanomas.

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Area of Science:

Oncology
Surgical Oncology
Dermatology

Background:

The utility of elective lymph node dissection (ELND) in stage I melanoma remains a long-standing debate.
Previous studies comparing ELND with wide local excision (WLE) have yielded conflicting results regarding survival benefits.

Purpose of the Study:

To resolve the controversy surrounding ELND in stage I melanoma by conducting a comprehensive meta-analysis.
To evaluate the impact of ELND on survival rates in melanoma patients, specifically differentiating between all stages and intermediate thickness melanomas.

Main Methods:

A meta-analysis was performed, pooling data from 15 studies involving 3,409 patients who underwent ELND for all melanoma stages.
A subgroup analysis included eight studies with 1,336 patients who had ELND for intermediate thickness melanomas (0.76-3.99 mm).

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Main Results:

No statistically significant improvement in 5-year survival was observed for the overall group of patients treated with ELND (p > 0.05).
A significant improvement in 5-year survival was demonstrated in the subgroup of patients with intermediate thickness melanomas (p < 0.0001).

Conclusions:

Elective lymph node dissection (ELND) does not confer a significant survival advantage for all stage I melanoma patients.
ELND may be a valuable therapeutic option for improving the prognosis of patients diagnosed with intermediate thickness melanomas.