Morbidity and Outcome after Sentinel Lymph Node Dissection in Patients with Early-Stage Malignant Cutaneous Melanoma

Abstract

Staging of early-stage melanoma with the SLN dissection by use of the blue dye technique combined to lymphoscintigraphy and immunohistochemistry is reliable and safe, with less morbidity than elective lymphadenectomy. Long-term follow-up is mandatory to establish the exact reliability of SLN dissection.

Postoperative morbidity of lymph node excision for cutaneous melanoma-sentinel lymphonodectomy versus complete regional lymph node dissection

“…We observed an overall complication rate of 13.9%, which is in agreement with other studies, which have reported complication rates between 4.6 and 20% [5][6][7][8][9][10][11][12]. The most frequent short-term complication was seroma (6.9%).…”

“…Only one wound infection resulted in secondary healing. Wound infection rates of 6-29%, observed after CLND [4,6,11,14,16,8,18,26] justify the use of perioperative antibiotic prophylaxis. Two prospective studies have, however, demonstrated only a trend towards fewer infections in patients given prophylactic antibiotics [26,27].…”

The role of sentinel lymph node biopsy for melanoma: Evidence assessment

“…However, almost 3 decades of evidence exists regarding the regional failure rate after delayed CLND and immediate CLND (ELND or after a positive SLNB). 11,13,16,29,[50][51][52][53][54][55][56][57][58][59] The rates of nodal relapse reported are in the range of 0% to 10% for CLND after a positive SLNB or ELND, and 9% to 36% after CLND for gross disease depending on the amount of gross disease (as high as 63% with bulky disease), number of positive nodes, and the status of extracapsular spread. 11,29,51-65 Regional control does not appear to be compromised by SLNB.…”

“…13,58 Realizing that definitive comparisons are impossible between studies, postoperative complications after SLNB are observed in about 5% in comparison with 36% after ELND. 11,13,59 SLNB is not without morbidity. Results of the largest reported prospective randomized trial involving 79 centers with more than 3600 patients undergoing SLNB found an overall 4.6% complication rate, most of which were minor versus a 23.2% complication rate after CLND in the setting of a positive SLNB.…”

Sentinel lymph node biopsy and melanoma: 2010 update

“…29,[32][33][34][35] The two largest randomized, prospective studies that have performed morbidity analysis on patients undergoing these procedures are the MSLT-I and Sunbelt Melanoma trial. The MSLT-I reported that when comparing WLE alone to WLE plus SLNB, the rates of total complications, which included wound separation, seroma/hematoma formation, infection, and skin graft failure, were very similar (13.9% vs 13.8%).…”