The prognostic impact of the extent of lymph node dissection in patients with stage III melanoma

Aims To analyse disease-free and overall survival in 67 melanoma patients who underwent dissection for clinically apparent regional lymph node metastases, taking into account the total number of excised lymph nodes. Methods After a median follow-up time of 16 months, 47 recurrences were observed and 43 patients died. The median disease-free and overall survival intervals were 14 and 24 months respectively. Results Multivariate analyses revealed that the number of excised lymph nodes had a significant impact on overall survival (P = 0.036) but not on disease-free survival (P = 0.97). Extranodal growth was the only statistically significant prognostic factor both for disease-free (P = 0.005) and overall (P = 0.038) survival. Age, nodal basin, primary tumor ulceration, tumor thickness and number of positive lymph nodes were not significant prognostic factors. Conclusions Our results suggest that the total number of lymph nodes excised in the dissection has impact on overall survival of stage III melanoma patients and should be considered in clinical assays.