Completion lymph node dissection is unnecessary after positive sentinel lymph node in melanoma - a case series analysis

Abstract

In recent times, significant trials showed that sentinel lymph node biopsy alone was therapeutic in melanoma and no further surgery was necessary even if sentinel lymph node biopsy was found positive. In this retrospective study, we aimed to determine the prognostic importance of the total number of excised lymph nodes after sentinel lymph node biopsy in pN1 stage III melanoma patients from a single tertiary cancer centre. A total of 194 stage III primary melanoma patients with only one metastatic regional lymph node (pN1) determined by sentinel lymph node biopsy were included in the study. All patients with pathologically positive sentinel lymph node biopsy underwent a completion of lymphadenectomy. The numbers of excised lymph nodes were divided into the groups 1 to 5, 6 to 10, 11 to 15, and ≥ 16. The estimated 5-year relapse-free survival of all patients was 44.3% and there was no significant association between increasing excised lymph node groups and relapse-free survival (p = 0.3). Moreover, the 5-year overall survival for all cases was 48.7% and no significant association between increasing excised lymph node groups and overall survival was observed (p > 0.05). In conclusion, we suggest no prognostic impact for the extended removal of lymph nodes on relapse and outcome in pN1 melanoma patients after sentinel lymph node biopsy.