Abstract
Background: Sentinel lymph node (SLN) biopsy has become widely accepted as a method of staging the regional lymph nodes for patients with melanoma. Although it is often stated that SLN biopsy is a minimally invasive procedure associated with few complications, a paucity of data exists to specifically determine the morbidity associated with this procedure. This analysis was performed to evaluate the morbidity associated with SLN biopsy compared with completion lymph node dissection (CLND).
Methods: Patients were enrolled in the Sunbelt Melanoma Trial, a prospective multi-institutional study of SLN biopsy for melanoma. Patients underwent SLN biopsy and were prospectively followed up for the development of complications associated with this technique. Patients who had evidence of nodal metastasis in the SLN underwent CLND. Complications associated with SLN biopsy alone were compared with those associated with SLN biopsy plus CLND.
Results: A total of 2120 patients were evaluated, with a median follow-up of 16 months. Overall, 96 (4.6%) of 2120 patients developed major or minor complications associated with SLN biopsy, whereas 103 (23.2%) of 444 patients experienced complications associated with SLN biopsy plus CLND. There were no deaths associated with either procedure.
Conclusions: SLN biopsy alone is associated with significantly less morbidity compared with SLN biopsy plus CLND.
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REFERENCES
Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992; 127:392–9.
Reintgen DS, Cox EB, McCarthy KM. Efficacy of elective lymph node dissection in patients with intermediate thickness primary melanoma. Ann Surg 1983; 198:379–85.
Reintgen DS, Balch CM, Kirkwood J, Ross MI. Recent advances in the care of the patient with malignant melanoma. Ann Surg 1997; 225:1–14.
Holmes EC, Mosley HS, Morton DL, Clark W, Robinson D, Urist MM. A rational approach to the surgical management of melanoma. Ann Surg 1977; 186:481–90.
Baas PC, Schraffordt KH, Hockstra HJ, van Bruggen JJ, van der Weele LT, Oldhoff J. Groin dissection in the treatment of lower extremity melanoma. Short term and long term morbidity. Arch Surg 1992; 127:281–6.
Beitsch P, Balch C. Operative morbidity and risk factor assessment in melanoma patients undergoing inguinal lymph node dissection. Am J Surg 1992; 164:462–5.
Ingvar C, Erichsen C, Jonsson PE. Morbidity following prophylactic and therapeutic lymph node dissection for melanoma—a comparison. Tumori 1984; 70:529–33.
Urist MM, Maddox WA, Kennedy JE, Balch CM. Patient risk factors and surgical morbidity after regional lymphadenectomy in 204 melanoma patients. Cancer 1983; 51:2152–6.
Karakousis CP, Stahl L, Moore R, Holyoke ED. Lymph node dissection in malignant melanoma. J Surg Oncol 1980; 13:245–52.
Bland K, Klamer T, Polk H Jr, Knutson C. Isolated regional lymph node dissection: morbidity, mortality and economic considerations. Ann Surg 1981; 193:372–6.
Hughes TM, Thomas JM. Combined inguinal and pelvic lymph node dissection for stage III melanoma. Br J Surg 1999; 86:1493–8.
McMasters KM, Reintgen DS, Ross MI, et al. Sentinel lymph node biopsy for melanoma: how many radioactive nodes should be removed? Ann Surg Oncol 2001; 8:192–7.
Schrenk P, Rieger R, Shamiyeh A, Wayand A. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer 2000; 88:608–14.
Jansen L, Nieweg OE, Peterse JL, et al. Reliability of sentinel lymph node biopsy for staging melanoma. Br J Surg 2000; 87:484–9.
Wrone DA, Tanabe KK, Cosimi AB, et al. Lymphedema after sentinel lymph node biopsy for cutaneous melanoma: a report of 5 cases. Arch Dermatol 2000; 136:511–4.
Leong SP, Donegan E, Heffernon W, Dean S, Katz JA. Adverse reactions to isosulfan blue during selective sentinel lymph node dissection in melanoma. Ann Surg Oncol 2000; 7:361–6.
Bold RJ, Mansfield PF, Berger DH, et al. Prospective, randomized, double-blind study of prophylactic antibiotics in axillary lymph node dissection. Am J Surg 1998; 176:239–43.
Wagner JD, Park HM, Coleman JJ, Love C, Hayes JT. Cervical sentinel lymph node biopsy for melanomas of the head and neck and upper thorax. Arch Otolaryngol Head Neck Surg 2000; 126:313–21.
Ollila DW, Foshag LJ, Essner R, Setern SL, Morton DL. Parotid region lymphatic mapping and sentinel lymphadenectomy for cutaneous melanoma. Ann Surg Oncol 1999; 6:150–4.
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W.W.R. and S.L.W. contributed equally to this work.
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Wrightson, W.R., Wong, S.L., Edwards, M.J. et al. Complications Associated With Sentinel Lymph Node Biopsy for Melanoma. Ann Surg Oncol 10, 676–680 (2003). https://doi.org/10.1245/ASO.2003.10.001
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DOI: https://doi.org/10.1245/ASO.2003.10.001