Purpose: To determine the 4-year-outcomes for resected stage III melanoma patients treated by a specialist melanoma surgeon.

Methods: Between July 2008 and June 2010, 39 regional lymphadenectomies were undertaken on 37 patients. At least 4-year follow-up data was collected with a retrospective chart review and Kaplan-Meier survival analysis was performed.

Results: The site of lymphadenectomy was the axilla and ilioinguinal (groin and pelvis) basin in 18 and 11 cases respectively while neck, groin and pelvis constituted 4, 4 and 2 cases respectively. 7 patients presented with an unknown primary, 3 with distant metastases, 4 with recurrence after lymphadenectomy and 2 following a positive sentinel lymph node biopsy.

The median duration of follow-up was 46.6 months (range: 3.5 to 70.3 months). Seroma and lymphoedema were treated in 30% and 46% respectively. Infection required antibiotics in 20% and abscess drainage in 1. Wound dehiscence was reported in 10%, DVT and haematoma were reported in 1 case each.

2 patients had adjuvant radiotherapy and chemotherapy while 5 had adjuvant radiotherapy alone. 2 patients remained disease-free but 4 developed distal metastases, 1 developed nodal recurrence with a median survival of 8.9 months.

51% (19) developed new recurrences with multi-site metastases, distal metastases, isolated regional and local disease accounting for 6, 9, 1 and 3 cases respectively. 62.2% of the patients were alive with a median disease-free-survival and overall survival of 52.1 months of 56.6 months respectively. 14 patients have died with a mean survival of 26.3 months.

Conclusion: Lymphadenectomy caused acceptable post-operative morbidity and resulted in significant 4-year overall survival. In this study, adjuvant radiotherapy does not appear to make a significant contribution to the overall survival.