There is no consensus about the optimal extent of surgery for patients with melanoma metastases to inguinal nodes, and this is further complicated by variations in terminology for these dissections. In patients without clinical evidence of iliac metastases, we routinely perform a superficial groin dissection (SGD), which clears node-bearing tissue superficial to the fascia lata. We hypothesized that SGD provides regional tumor control comparable to published experience with deep groin dissection (DGD) and iliac and obturator dissection (IOD), but with less morbidity.

A retrospective review of a prospectively collected database evaluated patients undergoing SGD April 1994 through May 2008. Patients with clinical evidence of iliac metastases were excluded. Clinical and pathologic data regarding recurrence and survival were evaluated.

We identified 53 primary SGD: 27 for clinically palpable disease, and 25 for microscopic disease. Number and percentage of positive nodes were similar between groups. Median followup was 39 months, and two patients had primary recurrence in the groin (one in each group). Two additional patients had concurrent groin and systemic recurrence. Five-year Kaplan-Meier estimates for ipsilateral groin recurrence prior to systemic disease, were similar at 9.7% (SE 6.5) and 7.7% (SE 7.4), for microscopic and palpable disease respectively. Similarly, survival was comparable between groups (73% and 82%). Toxicities were comparable to previously published data.

SGD provides regional control rates similar to DGD and IOD, for lymph node metastases clinically limited to the groin, whether occult or clinically evident.