Axillary and Epitrochlear Lymph Node Dissection for Melanoma

Abstract

Indications for regional lymph node dissection in melanoma have evolved over time. Once the decision to proceed with axillary lymph node dissection (ALND) has been made, the goal of the procedure in patients with melanoma is complete resection of all lymph nodes (levels I, II, and III) in the axillary basin, respecting the anatomic relations of the axillary vein, thoracodorsal neurovascular bundle, and long thoracic nerve. Performed properly, ALND offers excellent locoregional disease control with acceptably low morbidity rates. While metastasis to epitrochlear nodes is a rare event, epitrochlear lymph node dissection may similarly be an important component of treatment for melanoma patients.