Lymph node removal (lymphadenectomy) for melanoma

Surgery Overview

Lymphadenectomy is surgery to remove cancerous lymph nodes . Some lymph nodes are located near the surface of the body, while others are deep in the abdomen or around organs, such as the heart or liver. Lymphadenectomy is done to cure melanoma that has spread only to the lymph nodes and to prevent melanoma from spreading farther (metastasizing).

General anesthesia is usually used for a lymphadenectomy. An incision is made in the skin over the lymph nodes to be removed. The type and depth of the incision varies depending upon the location of these lymph nodes. The lymph nodes are removed along with nearby lymphatic tissue and some underlying soft tissue.

What To Expect After Surgery

Recovery depends upon the extent of the surgery and the site where the lymph nodes were removed.

Why It Is Done

Lymphadenectomy may be done for stage II or III melanoma to remove lymph nodes that have melanoma in them.

How Well It Works

Not all studies show that lymphadenectomy increases survival. But many experts believe it gives the best chance of a cure for people who have melanoma with involvement of regional lymph nodes but with no evidence of distant metastases. ¹

Risks

Surgery to remove lymph nodes can cause many side effects. The risks of lymphadenectomy include:

• Buildup of fluid at the site of surgery (seroma).
• Infection.
• Swelling of a limb affected by removal of the lymph nodes (lymphedema).
• Numbness, tingling, or pain in the surgical area.
• Breakdown (sloughing) of skin over the area.

What To Think About

The decision to have a lymphadenectomy is not simple. It depends on your age, the location and thickness of the primary melanoma, results of the sentinel node biopsy , and other possible treatments. Discuss these issues with your health professional before deciding whether to have a lymphadenectomy.

Not all lymph node enlargement indicates involvement with melanoma. Other conditions that cause lymph node swelling, such as acne or infection, could occur at the same time as the melanoma. Such conditions should be ruled out before lymphadenectomy is done.

Swelling after surgery ( lymphedema ) can be prevented or controlled by use of antibiotics , elastic stockings, massage, and diuretics .

Lymphadenectomy usually is not needed if melanoma has not spread to the lymph nodes.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

Citations

1. Kanzler MH, Mraz-Gernhard S (2001). Treatment of primary cutaneous melanoma. JAMA, 285(14): 1819–1821.