Elective lymph node dissection in primary malignant melanoma

The role of elective lymph node dissection (ELND) in primary malignant melanoma is controversial. Our purpose was to evaluate the benefit of ELND regarding survival and disease-free survival in malignant melanoma of the trunk and extremities. By matched-pair analysis, 375 patients treated by wide local excision (WLE) plus ELND were compared to 375 patients treated by WLE only. There was no difference in survival between the two treatment groups; however, the disease-free interval was significantly higher in the collective treated by WLE plus ELND (P<0.05). Increased survival rates were noted for intermediate tumor thickness of 1.51-4.0 mm for the WLE + ELND group although the difference was not significant (P = 0.14), and disease-free survival was significantly improved in this group (P<0.001). ELND elicited a higher benefit in male patients with intermediate thickness melanoma. Our results confirm the findings of several studies that ELND improves the outcome after primary treament of malignant melanoma of intermediate tumor thickness.