Metastatic melanoma (stage III) and lymph node dissection at a university hospital facility

Background: Malign melanoma continues to present a severe health problem, and the incidence is still raising. Nodal status and ulceration of the primary melanoma are strong prognostic factors. The main treatment of node-positive melanomas (stage III) is complete lymph node dissection. The aim of this study was to describe the outcome in patients with stage III melanoma who underwent completion lymphadenectomy at a department of plastic surgery. Methods: Retrospectively, we included all patients who underwent complete lymph node dissection in the period from 2008 to 2012 subsequent to a positive sentinel node biopsy or palpable metastasis from a cutaneous malign melanoma. Primary outcomes were disease-free survival and melanoma-specific survival. Results: We included 150 patients with an average age of 57 (16–82) years. Melanoma thickness was 3.1 (0.53–15) mm. Ulceration of primary tumor was present in 35 %. Complete lymph node dissection was performed in the neck, axilla, inguinal region, and aberrant region. There was no difference in occurrence of nodal metastases comparing the regions. Seroma was most frequent in the axilla (23.5 %) and inguinal region (18.9 %). Lymphedema occurred in the inguinal region (15.1 %) and the axilla (4.7 %), and wound infection occurred in the inguinal region (30.2 %), the axilla (15.3 %), and the neck (11.1 %). The 5-year nodal recurrence rate was 16.9 % [95 % CI 8.2–33.1 %] and the 5-year rate of distant metastases was 48.3 % [95 % CI 36.5–61.8 %]. Overall survival was 51.8 % [95 % CI 35.6–65.8 %]. More than two nodal metastases worsened the prognosis (reference: <2 lymph nodes). Level of Evidence: Level IV, risk/prognostic study.