Axillary dissection in melanoma: prognostic variables in node-positive patients

Malignant melanoma is cancer of melanocytes (cells that produce the pigment melanin), which is usually found on the skin. The spread of this cancer to the regional lymph nodes is a major factor in determining prognosis. The usefulness of 14 variables in establishing the prognosis of patients with malignant melanoma and cancer-positive regional lymph nodes in the armpit area (axilla) was evaluated. Medical records of 197 patients with metastatic melanoma (melanoma that has spread from the primary to a secondary site) to the axillary lymph nodes were reviewed. All patients underwent axillary lymph node dissection. Three factors were significant independent predictors of survival: percent of positive nodes; absence of disease outside the node (extranodal); and site of melanoma. By combining these variables, subgroups of patients with differing prognoses were created. A good outcome could be expected for patients with 10 percent or less positive nodes, no extranodal disease, and melanoma located outside the trunk of the body. Poor prognosis was predicted for patients with extranodal disease and lesions on the trunk. There was always an unfavorable prognosis when there was a very high percent of positive lymph nodes. (Consumer Summary produced by Reliance Medical Information, Inc.)