Efficacy of elective lymph node dissection in 2,347 patients with clinical stage I malignant melanoma.

The results of a largely prospective but non-randomized study of 2,347 patients with clinical Stage I malignant melanoma have demonstrated that there are certain subgroups of patients who benefit substantially from ELND. Men with lesions of intermediate thickness (1.6 to 3.0 millimeters) benefited most from ELND, both in terms of disease-free and total survival rates. Ten year survival rates in patients who underwent ELND were more than 40 per cent higher than the rates in patients who underwent WE. Although total survival rates were not improved in patients with the thickest lesions (those in excess of 3.0 millimeters) disease-free rates in these patients were considerably higher after ELND. Women with lesions of the extremities thicker than 1.5 millimeters had significantly improved disease-free and total survival rates after ELND (ten year survival rates of up to 37 per cent higher after ELND). No women with lesions of the trunk appeared to benefit from this surgical procedure.