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Published on: January 26, 2024
Axillary Lymph Node Metastases of Melanoma: Management of Third-level Nodes
Daniele Gentile1, Piero Covarelli2, Franco Picciotto3
1Department of Surgery, St. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
Aim:
To state the limits of axillary lymphadenectomy in patients with metastatic melanoma.
Patients And Methods:
We performed a prospective study on patients submitted to axillary dissection for stage III melanoma. At surgery, the third-level nodes were separately dissected to be examined by the pathologist.
Results:
We analyzed 86 patients. In 93%, the third-level nodes were disease-free; none of the patients with previous positive sentinel nodes (SN) showed nodal metastases at level III. Patients (7%) found to have positive level III nodes had undergone therapeutic lymphadenectomy for bulky nodal disease.
Conclusion:
Our data show that axillary non-sentinel nodes of level III are usually disease-free in cases of previously positive SN, while they can be involved in the presence of bulky disease. A prerequisite allowing sparing of level III nodes after a positive SN biopsy is the meticulous research of all level I and II lymph nodes.
