[Lymphogenic metastasing of malignant melanoma (author's transl)]

Data of 378 melanoma patients treated surgically between 1969 and 1979 were evaluated in a retrospective analytic study. Histological criteria such as level of invasion (according to Clark) and tumour thickness (according to Breslow) were related to tendency for lymphogenic metastases and to life expectancy of patients. The level of invasion proved a better prognostic criterium than tumour thickness. In 202 lymphadenectomised patients it could be shown that the probablity of lymphogenic metastases is directly proportional to the level of invasion of the primary tumour. Histologically demonstrable lymphnode metastases were found in 47% of males and 38% of females with melanomas of invasion level III. Figures for melanomas with invasion level IV were 64% of males and 41% of females, and 100% of males but only 16% of females in melanomas of invasion level V. With negative lymphnode involvement the 5 year survival rate is significantly higher in females with invasion level IV and V or for melanomas with a vertical diameter of more than 2.25 mm than in males. Histologically established lymphnode metastases lead to a definitely worse prognosis for both sexes. A higher survival rate for females can then no longer be demonstrated.