Malignant melanoma of the lower extremity: evaluation of 453 patients.

Four hundred fifty-three patients are evaluated regarding 10-year survival rates. Females comprise 66% and males the remainder (34%). The absolute 10-year survival rate was 55.2% post therapy. Females had a remarkably better survival (64%) than the males (42%). Age did not affect the prognosis. Staging was most important in that 167 patients with Stage I had a 10-year survival of 66%, which dropped for the 263 patients in Stage II (24%), and of the 23 patients classified as Stage III, only one (4%) survived 10 years. Of the 202 patients in clinical Stage I, 102 were subjected to an elective groin dissection which revealed occult metastases to lymph nodes in 35, whose 10-year survival rate was 49%. In 100 patients, no elective groin dissection was performed, and 41 of these developed metastases to inguinal nodes at a later date. The 10-year survival for that group was 32% -- somewhat lower than the 49%. An elective groin dissection is indicated for invasive melanomas. An eleven percent mortality between the fifth and tenth year after therapy indicates that 10-year survival rates should be recorded for melanomas.