RESULTS OF LYMPH NODE DISSECTION IN CUTANEOUS LOWER EXTREMITY MELANOMA WITH III-V LEVEL OF INVASION WITHOUT CLINICALLY POSITIVE REGIONAL LYMH NODE METASTASES
Protsenko A.V., Pokhvalin I.V., Cobetskoy V.V., Efetova T.S.
Results of treatment of patients with cutaneous lower extremity melanoma with III–V Clark level of invasion were studied retrospectively for 22 years (1984–2004). Patients with clinically negative lymph nodes (LN) were divided into two groups accordingly to tactic after removal of primary tumor: 1 — elective lymph node dissection after 3–4 weeks; 2 — observation and delayed therapeutic lymph node dissection performed after LN became palpable. Overall survival was identical in both groups. Incidence of in-transit metastases was 2 times higher in group after prophylactic lymph node dissection than in group with observation and delayed therapeutic lymph node dissection, accordingly, 20,0 ± 3,7% (23 from 115) and 9,4 ± 2,9% (9 from 96). Prophylactic lymph node dissection does not improve survival and may increase the incidence of in-transit metastases in patients with cutaneous lower extremity melanoma.
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