Morbidity following prophylactic and therapeutic lymph node dissection for melanoma--a comparison

Between 1976 and 1982, 110 isolated regional lymph node dissections (RLND) for melanoma were performed as a prophylactic procedure (PLND) in 44 and therapeutic procedure (TLND) in 64 patients. The prevalence of metastases was 20% in the PLND group. The number of patients with complications in the PLND were 17/44 (39%) and in the TLND 39/64 (61%). Local wound complications dominated. Serum collections occurred in 25% of PLND patients and 45% of TLND patients (p less than 0.05), and infections, skin necrosis, and cellulitis in respectively 11% and 22%. The incidence of lymphedema was 10% in PLND and 23% in TLND patients. Regarding the anatomic sites, there were significantly more seromas after axillary dissection in TLND patients compared with PLND patients (p less than 0.05). However, no difference was observed between groin dissections in the 2 groups. The socioeconomic effects in terms of hospital stay and further therapeutic measures were pronounced when complications occurred.