Complications of sentinel lymph node biopsy for melanoma – A systematic review of the literature

Moody, J.A.; Ali, Rabia; Carbone, Antonino; Singh, Sohni G; Hardwicke, Joseph

doi:10.1016/j.ejso.2016.06.407

Cited by 88 publications

(67 citation statements)

References 38 publications

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“…A total of 2.1% of the patients in our study developed postoperative wound infections, which is in line with previous data, reporting infection rates between 0.3 and 19% . In the literature, the seroma rates range from 0 to 38%, corresponding to the 19.6% seroma rate in our study. Similar seroma incidences were also reported in SLNB for breast cancer .…”

Section: Discussionsupporting

confidence: 91%

“…Since involvement of the regional lymph nodes is one of the most important prognostic factors in melanoma, sentinel lymph node biopsy (SLNB) has been adopted as a routine procedure in the staging protocol of patients with an intermediate‐thickness melanoma and without clinical evidence of locoregional or distant metastases . The most common postoperative complications following SLNB are wound infections and development of seroma, which is defined as a collection of lymphatic fluid in a tissue or organ. Although not life threatening, seroma development after SLNB causes discomfort and may increase the possibility of surgical site infection.…”

Section: Introductionmentioning

confidence: 99%

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Predicting risk for seroma development after axillary or inguinal sentinel lymph node biopsy in melanoma patients

et al. 2018

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Predicting risk for seroma development after axillary or inguinal sentinel lymph node biopsy in melanoma patients

et al. 2018

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“…A systematic review by Moody et al . that includes 21 articles and 9047 patients, reported an overall complication rate of 11.3% with infection rates ranging from 0.3% to 19% . Our study showed similar results with overall complication and wound infection rates of 9.5% and 5.9%, respectively.…”

Section: Discussionsupporting

confidence: 83%

“…Although SLNB is a standardized surgical procedure, the incidence of early post‐operative morbidity is currently not well defined in the literature. A recent systematic review showed postprocedural complications ranging from 1.8% to 29.9%, with a predominance of local infections that ranged from 0.3% to 19.0% . This study aims to describe the overall post‐operative complication rate of SLNB that occurred at our institution and to identify the possible risk factors.…”

Section: Introductionmentioning

confidence: 98%

Sentinel lymph node biopsy in patients with malignant melanoma: analysis of post‐operative complications

Solari

Bertoglio

Boscaneanu

et al. 2019

ANZ Journal of Surgery

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Background: This study investigates the incidence of post-operative complications and risk factors of sentinel lymph node biopsy (SLNB) in melanoma patients. Methods: A retrospective cohort study was conducted at a single cancer institution on 408 consecutive SLNBs. Results: Fifty-five post-operative complications occurred in 39 (9.5%) patients and included: wound infection in 24 (5.9%), seroma and lymphorrhea in 15 (3.7%), wound dehiscence in seven (1.7%), lymphocele in six (1.5%) and others in three (0.7%). Univariate analysis failed to identify possible risk factors (i.e. gender, age, lymph node region, number of excised lymph nodes, Breslow index, pT levels, comorbidities, length of surgery and hospital stay). Metastatic sentinel nodes occurred in four of 135 (3%) patients with thin melanoma (Breslow <1 mm) and in 68 of 262 (25.9%) patients with Breslow >1 mm. Conclusion: For patients with thin melanoma in whom the incidence of lymph node metastasis is low, the reported post-operative morbidity of almost 10% of SLNB highlights the need for careful patient selection.

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“…The overall complication rate for SLN biopsy for melanoma was 11.3%, and the incidence of infection was 2.9%, seroma 5.1%, hematoma 0.5%, lymphedema 1.3%, and nerve injury 0.5%. 11 Patients with melanoma who undergo complete lymph node dissection (CLND) have a 37.2% complication rate, including wound infection/ breakdown (21%), lymphedema (18%), and seroma (18%). 12 It is likely these complications were factors in many patients refusing CLND.…”

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confidence: 99%

SPECT/CT: Looking Beyond Sentinel Lymph Node Identification for Improving Patient Outcomes

Sibley

Subramaniam

2017

Ann Surg Oncol

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TXSentinel lymph node (SLN) identification is required for accurate prognostication for patients with head and neck melanoma.1 In clinical practice, identifying SLNs can be challenging. This is particularly true for patients with head and neck melanomas, which are associated with higher rates of false negative biopsies.2 Additionally, the drainage pattern of the head and neck is complex. Drainage patterns can be discordant from predicted patterns, 3,4 and a single lesion can drain to multiple basins. [4][5][6][7] Unfortunately, these challenges have resulted in a relative paucity of research for SLN studies in patients with head and neck melanoma.Planar sentinel lymphoscintigraphy is a highly functional and sensitive test to demonstrate lymphatic channels, and to identify SLNs and nodes with microscopic nodal metastasis. It provides valuable information about individual lymphatic collectors reaching the SLN, dynamic arrival time of the radiotracer at the SLN, number of lymphatic collectors leaving the melanoma site, and relative intensity of lymph nodes; however, it lacks information about detailed anatomy that would be helpful in surgical planning and identifying sentinel nodes closer to the injection site due to blooming artifact. Single photon emission computed tomography/computed tomography (SPECT/CT) overcomes this disadvantage and provides high-resolution anatomic images to localize the SLNs and second-tier lymph nodes. It has been demonstrated that SPECT/CT not only increases detection of metastatic involvement 8 but has also been associated with significant cost reduction. 9Trinh and colleagues performed a retrospective review 10 of 118 patients undergoing an SLN biopsy for head and neck cutaneous melanoma, all of whom underwent a SPECT/CT. Patients were categorized into two groups: 1 those in whom SPECT/CT did not identify additional nodal basins; and 2 those in whom SPECT/CT did identify additional basins. Two radiologists interpreted all the imaging studies and answered questions regarding the utility of SPECT/CT in addition to planar imaging. SLNs were then identified on the basis of radioactivity and/or dye uptake, and biopsied. The surgeons performing the procedure answered a survey regarding the impact of SPECT/CT for the extent of SLN biopsy incision and utility in detecting the SLNs. Long-term outcomes were then described. Of the patients with positive lymph node disease, 10% (2/20) were missed by planar imaging alone. The survey results suggest that SPECT/CT influenced the extent of the incision and helped to localize a SLN close to the primary tumor. In addition, the study by Trinh et al. showed that the sites of locations of SLNs where SPECT/CT is most helpful are the supraclavicular and peri-parotid regions. SPECT/CT added little information in identifying new SLNs in other neck levels.The outcomes addressed in their study, including disease-free survival, overall survival, locoregional recurrence, and distant recurrence, are of utmost importance to patients and clinicians. It is important t...

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Complications of sentinel lymph node biopsy for melanoma – A systematic review of the literature

Cited by 88 publications

References 38 publications

Predicting risk for seroma development after axillary or inguinal sentinel lymph node biopsy in melanoma patients

Predicting risk for seroma development after axillary or inguinal sentinel lymph node biopsy in melanoma patients

Sentinel lymph node biopsy in patients with malignant melanoma: analysis of post‐operative complications

SPECT/CT: Looking Beyond Sentinel Lymph Node Identification for Improving Patient Outcomes

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