Sentinel-lymph-node biopsy (SLNB) for melanoma is not complication-free

Wasserberg, Nir; Tulchinsky, Hagit; Schachter, Jacob; Feinmesser, Meora; Gutman, Haim

doi:10.1016/j.ejso.2004.06.021

Cited by 65 publications

(57 citation statements)

References 17 publications

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“…Specifically, compared to studies evaluating complications from inguinal sentinel LN biopsy for malignant disease, the rate described here was higher than some [5,6], but lower than others [7,10]. Further, infection and seroma were the most common events reported in these procedures performed for clinical indications [5][6][7]10], which is also consistent with our findings. Notably, the rate of complications requiring medical intervention in this study is higher than one previously reported study describing LN excision in HIV-1 infected subjects for research purposes, which reported five events (3.6%) requiring intervention [11].…”

Section: Discussionsupporting

confidence: 81%

“…It is notable that rates of complications are significantly lower in retrospective studies, with overall complication rates reported from < 1% to 2% [8,9]. Nonetheless, comparing the risks of elective inguinal LN excision to the risks for excisions performed for clinical indications has some limitations because clinical procedures may involve multiple LN excisions or more extensive dissection [5][6][7][8][9][10]. Only one group to date has reported on outcomes following excisional inguinal LN biopsies for research purposes.…”

mentioning

confidence: 99%

“…Infection is one of the most common complications, with reported rates ranging from 3% to 23% of cases [5,6] following SLNB for melanoma. Seroma is also a common complication.…”

mentioning

confidence: 99%

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Safety of Excisional Inguinal Lymph Node Biopsies Performed for Research Purposes in HIV-1-Infected Women and Men

Meditz

Connick²,

McCarter³

2014

Surgical Infections

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Background: Most HIV-1 replication occurs in secondary lymphoid tissues, and evaluating these tissues is crucial to investigations of pathogenesis. Inguinal lymph nodes (LN) are obtained frequently for these studies as they are readily detectable in most individuals and provide abundant numbers of cells. Knowledge of the outcomes of inguinal LN excision for research purposes is important to inform accurately study participants and researchers of the potential risks. Methods: Data on surgical complications were collected in real time in HIV-1-infected subjects who underwent excisional inguinal LN biopsies for research purposes from February 1997 through June 2011. Data were analyzed retrospectively to determine the frequency of surgical complications using the Fisher exact test and nonparametric testing. Results: Eighty-seven research subjects underwent a total of 95 LN excisions. Thirty-six percent of subjects were female, 53% were white, 26% were black, 16% Hispanic, and 2% Native American. Median age was 36 y (22-52). The median CD4 + T cell count was 478 cell/mm 3 (range, 57-1117) and the median plasma HIV-1 RNA concentration was 4.1 log 10 copies/mL (range, 1.7-5.9). Minor complications including seroma, transient lymphedema, hematoma, and allergic reaction to surgical tape, occurred in 10% of procedures. Complications that required medical attention occurred in an additional 10% of procedures, and included cellulitis (5%), superficial incisional surgical site infection (3%), and seroma requiring aspiration (1%). Subjects with complications had a lower BMI (25; range, 16-38; n = 12) than others (28; range, 19-57; n = 40; p = 0.05) and tended to have higher platelets, (median, 259 · 10

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 99%

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Safety of Excisional Inguinal Lymph Node Biopsies Performed for Research Purposes in HIV-1-Infected Women and Men

Meditz

Connick²,

McCarter³

2014

Surgical Infections

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“…So gibt es einzelne Berichte über anaphy− laktische Reaktionen nach der Applikation von Patentblau und ähnlichen Farbstoffen [7]. Wasserberg et al (2004) fanden in ih− rer 8−Jahresbilanz in 20 % Komplikationen wie Hämatome, Sero− me, Lymphozelen, Wundinfekte und sensorische Störungen (bes. axillär) [16].…”

Section: Komplikationenunclassified

“…Wasserberg et al (2004) fanden in ih− rer 8−Jahresbilanz in 20 % Komplikationen wie Hämatome, Sero− me, Lymphozelen, Wundinfekte und sensorische Störungen (bes. axillär) [16].…”

Section: Komplikationenunclassified

Sentinel-Lymph-Node-Biopsie beim malignen Melanom

Konrad¹,

Wollina²

2005

Akt Dermatol

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EinführungBei primär kutanem Melanom ist die komplette chirurgische Ex− zision des Tumors mit Sicherheitsabstand die Methode der Wahl. Um die Tumorausbreitung festzustellen werden ± falls möglich ± noch vor dem operativen Eingriff die Staginguntersu− chungen durchgeführt, vor allem die sonographische Untersu− chung regionärer Lymphknoten. Der regionäre Lymphknotensta− tus ist neben der Tumordicke einer der wichtigsten prognosti− schen Faktoren, da die regionären Lymphknoten mit Abstand am häufigsten Sitz der Erstmetastasen sind [14].Ein Teil der Patienten, die klinisch einem N0−Stadium entspre− chen, weisen schon Mikrometastasen in den regionären Lymph− knoten auf. Deshalb wurde über einen längeren Zeitraum die prophylaktische Ausräumung der dem Tumor zugehörigen Lymphknotenregion unter der Hypothese durchgeführt, hier− durch möglicherweise bei geringer Tumorlast eine weitere Streuung zu verhindern (vor allem bei Melanomen mit einer grö− ßeren Tumordicke). Die Ergebnisse der elektiven Lymphknoten− dissektion gaben über Jahrzehnte Anlass zu Diskussionen. Von der elektiven Lymphknotendissektion profitierten nur bestimm− te Patientengruppen [3].Von Morton et al. (1992) AbstractThe technique of sentinel lymph node biopsy (SLNB) is a tool for melanoma staging that has been established for tumours thicker than 1 mm. The procedure is minimal invasive with reduced risk compared with elective lymph node dissection. Nevertheless, contraindications and adverse effects have to be considered. In patients with a primary melanoma without evidence of spread− ing SLNB provides a more precise staging that also has an influ− ence on further therapeutic options. On the other hand, data on prognosis improvement by SLNB are yet not sufficient for final confirmation.

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Importance of Sentinel Lymph Node Biopsy in Patients With Thin Melanoma

Wright

Scheri²,

Ye³

et al. 2008

Arch Surg

123

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The status of the sentinel node (SN) confers important prognostic information for patients with thin melanoma.Design, Setting, and Patients: We queried our melanoma database to identify patients undergoing sentinel lymph node biopsy for thin (Յ1.00-mm) cutaneous melanoma at a tertiary care cancer institute. Slides of tumor-positive SNs were reviewed by a melanoma pathologist to confirm nodal status and intranodal tumor burden, defined as isolated tumor cells, micrometastasis, or macrometastasis (Յ0.20, 0.21-2.00, or Ͼ2.00 mm, respectively). Nodal status was correlated with patient age and primary tumor depth (Յ0.25, 0.26-0.50, 0.51-0.75, or 0.76-1.00 mm). Survival was determined by log-rank test.Main Outcome Measures: Disease-free and melanomaspecific survival.Results: Of 1592 patients who underwent sentinel lymph node biopsy from 1991 to 2004, 631 (40%) had thin melanomas; 31 of the 631 patients (5%) had a tumor-positive SN. At a median follow-up of 57 months for the 631 patients, the mean (SD) 10-year rate of disease-free survival was 96% (1%) vs 54% (10%) for patients with tumornegative vs tumor-positive SNs, respectively (PϽ.001); the mean (SD) 10-year rate of melanoma-specific survival was 98% (1%) vs 83% (8%), respectively (PϽ.001). Tumorpositive SNs were more common in patients aged 50 years and younger (P=.04). The SN status maintained importance on multivariate analysis for both disease-free survival (PϽ.001) and melanoma-specific survival (PϽ.001). Conclusions:The status of the SN is significantly linked to survival in patients with thin melanoma. Therefore, sentinel lymph node biopsy should be considered to obtain complete prognostic information.

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Sentinel-lymph-node biopsy (SLNB) for melanoma is not complication-free

Cited by 65 publications

References 17 publications

Safety of Excisional Inguinal Lymph Node Biopsies Performed for Research Purposes in HIV-1-Infected Women and Men

Safety of Excisional Inguinal Lymph Node Biopsies Performed for Research Purposes in HIV-1-Infected Women and Men

Sentinel-Lymph-Node-Biopsie beim malignen Melanom

Importance of Sentinel Lymph Node Biopsy in Patients With Thin Melanoma

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