Surgical management of BANS malignant melanoma

Because melanomas of the upper back, posterior arm, neck, and scalp (BANS) have been shown to be at high risk for recurrence and metastases, a tendency is to carry out wide excision (WE) and elective radical node dissection (RND) for patients with such lesions. To investigate whether this regimen improves the survival rate, we reviewed retrospectively 62 patients with clinical stage I BANS melanoma. Forty-five patients were treated by WE alone and 17 patients were treated by WE and RND (WE + RND). The male:female ratio was 1.5:1 for WE and 1.8:1 for WE + RND. The mean age was 52.9 +/- 15.3 years for WE and 48.2 +/- 12.5 years for WE + RND (p = not significant [NS]). The overall survival rate at 1, 3, and 5 years was 98%, 76%, and 71% for WE and 100%, 88%, and 76% for WE + RND (p = NS). The disease-free survival rate at 1, 3, and 5 years was 91%, 76%, and 71% for WE and 100%, 88%, and 76% for WE + RND (p = NS). In conclusion, WE + RND does not improve survival of patients with stage I BANS melanoma.