Risk factors for lymph node metastasis in malignant melanoma

: The elective and the therapeutic lymph node dissection are discussed for therapy of malignant melanoma. We analyzed the significance of prognostic factors for the development of lymph node metastasis. Reviewing the records of 388 patients with malignant melanoma between 1983 and 1994, 230 patients were classified for clinical stadium I and II at the time of primary therapy. 148 patients (64.3%) developed positive lymph nodes. Sex, age and ulceration tendency had no significant influence on prognosis. The nodular type of melanoma metastasized significantly most frequently in the regional lymph nodes (75.6%), followed by the the acrolentiginous melanoma 64.0%), the lentigo maligna melanoma (60.0%) and the superficial spreading melanoma (45.7%). With tumor staging from pT1 (38.5%) to pT4 (78.1%) positive lymph nodes significantly developed. The malignant melanomas of the trunk had the strongest tendency for lymph node metastasis. For patients with histologically confirmed nodular malignant melanoma, tumor staging pT3 and pT4 or malignant melanomas of the trunk we see the indication for an elective lymph node dissection.