Abstract
The role of pelvic lymphadenectomy in melanoma metastatics to the superficial inguinal region remains controversial. Some authors advocate aggressive surgical treatment, whereas others state that outcome depends more on extent of disease rather than extent of treatment. We performed a retrospective clinical and pathological review of 14 patients having superficial (SLND) or combined inguinal lymphadenectomy (CLND) for melanoma of the lower extremity. A total of 8 SLNDs and 6 CLNDs were performed between 1990 and 2003. The time between lymphadenectomy and the moment of analysis was between 36 and 71 months. The number of involved superficial lymph nodes, lymph node size, and the presence of extracapsular spread were associated with the pelvic nodal involvement and poorer prognosis. Three of 6 (50%) patients who underwent CLND lived over 3 years, while only 1/9 (11%) patients who underwent SLND survived over 3 years. CLND provides significant prognostic information for stage III patients with inguinal lymph node metastases and may be therapeutic for those with pelvic lymph node metastases. CLND is the operation of choice for lower extremity melanoma patients with regional metastases to the inguinal area.
