Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities.

Background. The benefit of elective lymph node dissection (ELND) for the treatment of the nonmetastasized malignant melanoma has been assessed differently until today. Methods. Nine medical centers with a different ELND practice but comparable standards regarding diagnosis, excision of the primary tumors, classification, and follow-up, have collected their data (primarily ascertained prospectively) of 3616 patients of the tumor categories pT2 to pT4NOMO to produce an unbiased analysis of the prognostic benefit of ELND, and to find the indications for its application. The data are based on patients 70 years of age and younger with a primary melanoma of the skin, who have been followed for at least 4 years (median, 9.6 years). The stratification (according to pT cate-

Benefit of Elective Lymph Node Dissection in Subgroups of Melanoma Patients

The Case Against Elective Lymphadenectomy

The role of elective lymph node dissection (ELND) in the management of primary melanoma of the skin is a controversial subject. Some authorities consider the indications for this procedure to be broad, whereas others rarely recommend ELND. Voluminous literature reflects these divergent opinions. Unfortunately, this can be confusing for the practitioner advising a patient with melanoma. We review arguments for and against ELND and review some of the most important studies of the effects of ELND on survival. We attempt to elucidate the sources of controversy inherent in these survival studies. Criteria for the selection of appropriate candidates for ELND are discussed. ELND with hyperthermic limb perfusion is also briefly reviewed.

https://www.jaad.org/article/S0190-9622(94)70057-5/pdf

Elective lymph node dissection for melanoma.

Elective lymph node dissection (ELND) for primary cutaneous melanoma remains controversial in spite of the fact that it has been considered the standard of care for many years. Nevertheless, some surgeons rarely recommend ELND in any setting. The controversial aspects of ELND are explored and recommendations for the selection of appropriate candidates for ELND are discussed.

Elective regional lymph node dissection in cutaneous melanoma

A bicenter study compared survival probability in patients with malignant melanoma clinical stage I, treated by wide excision only or wide excision with elective lymph node dissection (ELND). ELND improved the survival only in men with primary tumors of 1.51–3.0 mm thickness. In female patients those without ELND showed a better survival. Thus, the total group of patients did not benefit from ELND, i.e. its value for the improvement of survival from malignant melanoma stage I could not be statistically proven.

Should elective lymph node dissection be used for treatment of primary melanoma

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Should elective lymph node dissection be used for treatment of primary melanoma