Elective lymph node dissection in primary malignant melanoma: a matched-pair analysis

The role of elective lymph node dissection (ELND) in primary malignant melanoma is still controversial. Our purpose in this study was to evaluate the benefit from ELND on survival and disease-free survival in malignant melanoma of the trunk and extremities. We performed a matched-pair analysis on 750 patients. There was no significant benefit from wide local excision (WLE) plus ELND compared with WLE in the total group. Increased survival rates were noted for tumour thicknesses of 1.51-4.0 mm for the WLE+ELND group, as shown by 10-year survival rates of 73.1% vs 60.3% (p = 0.14). A significant benefit of ELND was detected for malignant melanoma of the trunk (p < 0.05). Disease-free survival rates were significantly higher in the collective treated by additional ELND for all tumour thicknesses (p < 0.05) and even more in intermediate tumour thicknesses of 1.51-4.0 mm (p < 0.001). Our data give further support that ELND may be valuable in improving the prognosis in case of malignant melanoma of intermediate Breslow thickness.