Prognostic value of lymph node dissection in malignant melanoma

Area of Science:

• Oncology
• Surgical Oncology
• Dermatology

Background:

• Malignant melanoma is a significant public health concern.
• Regional lymph node status is a critical prognostic factor in melanoma.
• Understanding the impact of lymph node dissection is vital for patient management.

Purpose of the Study:

• To evaluate the prognostic significance of regional lymph node involvement in malignant melanoma.
• To determine the relationship between lymph node burden and patient survival.
• To assess survival outcomes based on the timing of lymph node dissection.

Main Methods:

• Retrospective review of 199 patients diagnosed with malignant melanoma.
• Analysis of histopathological findings of regional lymph nodes post-dissection.
• Correlation of lymph node status and number of positive nodes with survival rates.

Main Results:

• Patients with histologically negative lymph nodes demonstrated over threefold higher median survival rates compared to those with positive nodes.
• In patients with positive nodes, survival was directly related to the number of involved lymph nodes.
• Five-year tumor-free survival rates were 41% (1 positive node), 30% (2 positive nodes), and 18% (3+ positive nodes).
• Median survival for patients requiring dissection for positive palpable nodes at 1 month, 1 year, and >1 year post-excision was 21.5, 22, and 44 months, respectively.

Conclusions:

• Histologically negative regional lymph nodes are associated with significantly better survival in malignant melanoma.
• The number of positive lymph nodes is a key determinant of prognosis.
• Delayed regional node dissection may be associated with improved survival in select cases.