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Survival after groin dissection for malignant melanoma
C P Karakousis1, L J Emrich, D L Driscoll
1Surgical Oncology Department, Roswell Park Memorial Institute, Buffalo, NY 14263.
Surgery
|February 1, 1991
Summary
Malignant melanoma patients with positive lymph nodes have significantly lower survival rates. Thorough groin dissection, including deep nodes, is crucial for improving outcomes in these cases.
Area of Science:
- Surgical Oncology
- Dermatology
- Pathology
Background:
- Malignant melanoma prognosis is heavily influenced by lymph node metastasis.
- Groin lymph node status is a critical prognostic factor in melanoma management.
Purpose of the Study:
- To evaluate the impact of lymph node involvement on survival in malignant melanoma patients undergoing groin dissection.
- To assess the reliability of frozen section analysis in guiding surgical decisions for groin dissection.
Main Methods:
- Retrospective analysis of 158 patients with malignant melanoma undergoing superficial or radical groin dissection.
- Correlation of palpable and non-palpable lymph node status with histological findings and survival rates.
- Evaluation of deep lymph node involvement in patients with positive inguinal nodes.
Main Results:
- Histological involvement was found in 90% of palpable and 33% of non-palpable lymph nodes.
- Five-year survival rates were 77% for node-negative and 43% for node-positive patients.
- Deep lymph node involvement significantly reduced survival rates (28% vs. 48% for inguinal-only involvement).
- Frozen section analysis was deemed unreliable for determining microscopic nodal involvement.
Conclusions:
- Lymph node status is a critical determinant of survival in malignant melanoma.
- Radical groin dissection, especially when deep nodes are involved, is associated with improved survival.
- Accurate staging and thorough surgical procedures are essential for optimizing outcomes in melanoma patients with nodal metastasis.