Complications Associated With Sentinel Lymph Node Biopsy for Melanoma

Wrightson, William R.; Wong, Sandra L.; Edwards, Michael J.; Chao, Celia; Reintgen, Douglas S.; Ross, Merrick I.; Noyes, R. Dirk; Viar, Vicki; Cerrito, Patricia B.; McMasters, Kelly M.

doi:10.1245/aso.2003.10.001

Cited by 272 publications

(177 citation statements)

References 19 publications

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“…8, 19 Major complications did not occur, except for anaphylactic reaction to blue dye in two patients (0.4%). A recent study observed a comparable incidence of patent blue reactions of 0.5% in SLNBs in patients with breast cancer.…”

Section: Slnb Morbiditymentioning

confidence: 91%

Long-term follow-up reveals that ulceration and sentinel lymph node status are the strongest predictors for survival in patients with primary cutaneous melanoma

Vries¹,

Speijers²,

Bastiaannet³

et al. 2011

European Journal of Surgical Oncology (EJSO)

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, et al.. Long-term followup reveals that ulceration and sentinel lymph node status are the strongest predictors for survival in patients with primary cutaneous melanoma. EJSO -European Journal of Surgical Oncology, WB Saunders, 2011, 37 (8) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. 124 Patients (29%) relapsed during follow-up; 55 in the node-positive group who underwent CLND (55/119;46%) and 69 in the node-negative group (69/310;22%;p<0.001). In the node-negative group 17 patients developed recurrence in the regional node field; false-negative rate 11%.On multivariate analysis strongest prognostic factors for disease free survival (DFS) were primary melanoma ulceration and SLN positivity (Hazard Ratio (HR) of 2.2 and 2.3; p<0.001). For disease specific survival (DSS) the same was found to be true with a HR of 2.1 for ulceration and 2.0 for SLN positivity (p=0.001 and p=0.002 respectively). 10-Year DFS was 71% for node-negative patients compared with 48% for node-positive patients (p<0.001). 10-Year DSS was 77% for node-negative patients compared to 60% for node-positive patients (p<0.001).Conclusions: This study shows a remarkably high percentage of tumor-positive SLN. The long-term follow-up data confirm that tumor-positive SLN patients have a worse DFS and DSS than tumornegative SLN patients. Ulceration and SLN status proved to be the strongest prognostic factors for long-term DFS and DSS.

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Section: Slnb Morbiditymentioning

confidence: 91%

Long-term follow-up reveals that ulceration and sentinel lymph node status are the strongest predictors for survival in patients with primary cutaneous melanoma

Vries¹,

Speijers²,

Bastiaannet³

et al. 2011

European Journal of Surgical Oncology (EJSO)

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“…Melanoma patients were then stratified into 2 groups according to the anatomic region in which lymph node dissection was performed (ie, axillary and inguinofemoral). Six studies included both patients who had undergone axillary or inguinofemoral lymph node dissections, [16][17][18][19][20][21] ; the dissection groups from these studies are listed separately in Table 1. The pooled incidence of lower extremity lymphedema after inguinofemoral lymph node dissection was higher (18%) than for upper extremity lymphedema after axillary lymph node dissection (3%).…”

Section: Type Of Malignancymentioning

confidence: 99%

Lymphedema beyond breast cancer

Cormier

Askew

Mungovan

et al. 2010

Cancer

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387

170

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BACKGROUND: Secondary lymphedema is a debilitating, chronic, progressive condition that commonly occurs after the treatment of breast cancer. The purpose of the current study was to perform a systematic review and meta-analysis of the oncology-related literature excluding breast cancer to derive estimates of lymphedema incidence and to identify potential risk factors among various malignancies. METHODS: The authors systematically reviewed 3 major medical indices (MEDLINE, Cochrane Library databases, and Scopus) to identify studies that included a prospective assessment of lymphedema after cancer treatment. Studies were categorized according to malignancy, and data included treatment, complications, lymphedema measurement criteria, lymphedema incidence, and followup interval. A quality assessment of individual studies was performed using established criteria for systematic reviews. Bayesian meta-analytic techniques were applied to derive summary estimates when sufficient data were available. RESULTS: A total of 47 studies (7779 cancer survivors) met inclusion criteria: melanoma (n ¼ 15), gynecologic malignancies (n ¼ 22), genitourinary cancers (n ¼ 8), head/neck cancers (n ¼ 1), and sarcomas (n ¼ 1). The overall incidence of lymphedema was 15.5% and varied by malignancy (P < .001): melanoma, 16% (upper extremity, 5%; lower extremity, 28%); gynecologic, 20%; genitourinary, 10%; head/neck, 4%; and sarcoma, 30%. Increased lymphedema risk was also noted for patients undergoing pelvic dissections (22%) and radiation therapy (31%). Objective measurement methods and longer follow-up were both associated with increased lymphedema incidence. CONCLUSIONS: Lymphedema is a common condition affecting cancer survivors with various malignancies. The incidence of lymphedema is related to the type and extent of treatment, anatomic location, heterogeneity of assessment methods, and length of follow-up. Cancer 2010;116:5138-49.

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“…Potential complications include seroma, hematoma, usually transient and/or minor nerve palsies, lymphedema, and rarely anaphylaxis associated with isosulfan blue [Lucci et al, 2007;Roaten et al, 2005]. The overall complication rate of SLNB alone in the Sunbelt Melanoma Trial, which enrolled over 2100 patients, was 4.6% [Wrightson et al, 2003]. Given the overall low incidence of positive SLNB in patients with T1 lesions, it is inappropriate to perform SLNB routinely in this group of patients.…”

Section: Surgical Management Of Melanocytic Lesions Of Uncertain Malimentioning

confidence: 99%

“…While there remains uncertainty about the potential risks associated with the small amount of radioactivity used in radiocolloid lymphoscintigraphy, there is also concern regarding the use of blue dye during pregnancy. The most feared of these for all patients is a risk of anaphylaxis associated with the use of isosulfan blue, estimated to be as high as 1.1%, but closer to 0.1% in more recent and larger studies, and zero among the more than 2100 patients who underwent SLNB in the Sunbelt Melanoma Trial [Albo et al, 2001;Amr et al, 2005;Leong et al, 2000;Schwartz et al, 2003;Wilke et al, 2006;Wrightson et al, 2003]. Nonetheless, there is some hesitance about using the dye in patients who are pregnant based on this concern alone [Amersi & Hansen, 2006].…”

Section: Sentinel Lymph Node Biopsymentioning

confidence: 99%