title: Superficial and deep lymph node dissection for stage III cutaneous melanoma: clinical outcome and prognostic factors.
abstract: BACKGROUND
  The aims of this retrospective analysis were to evaluate the effect of combined superficial and deep groin dissection on disease-free and melanoma-specific survival, and to identify the most important factors for predicting the involvement of deep nodes according to clinically or microscopically detected nodal metastases.
  
  
  METHODS
  Between January 1996 and December 2005, 133 consecutive patients with groin lymph node metastases underwent superficial and deep dissection at the National Cancer Institute, Naples. Lymph node involvement was clinically evident in 84 patients and detected by sentinel node biopsy in 49 cases.
  
  
  RESULTS
  The 5-year disease-free survival was significantly better for patients with superficial lymph node metastases than for patients with involvement of both superficial and deep lymph nodes (34.9% vs. 19.0%; P = 0.001). The 5-year melanoma-specific survival was also significantly better for patients with superficial node metastases only (55.6% vs. 33.3%; P = 0.001).
  
  
  CONCLUSIONS
  Metastasis in the deep nodes is the strongest predictor of both disease-free and melanoma-specific survival. Deep groin dissection should be considered for all patients with groin clinical nodal involvement, but might be spared in patients with a positive sentinel node. Prospective studies will clarify the issue further.
authors: Department of Melanoma, Sarcoma and Skin Cancer, Via Mariano Semmola, Naples 80131, Italy.
authors: Nicola
authors: N
authors: Mozzillo
authors: Corrado
authors: C
authors: Caracò
authors: Ugo
authors: U
authors: Marone
authors: Gianluca
authors: G
authors: Di Monta
authors: Anna
authors: A
authors: Crispo
authors: Gerardo
authors: G
authors: Botti
authors: Maurizio
authors: M
authors: Montella
authors: Paolo Antonio
authors: PA
authors: Ascierto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006119:Groin / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate; D055815:Young Adult
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