SP41. Surgical Management of Lymphedema: The Cleveland Clinic 2-Year Experience

Abstract

PURPOSE:With widespread use of sentinel lymph node biopsy (SLNB) in melanoma, the accuracy of this procedure has been examined, quantified, and improved. However, the reported sensitivity and specificity of the procedure have ranged from 64 to 100%, with false-negative rates (FNR) ranging from 5.6 to 21%. Herein, we review a single-surgeon's experience in a large patient cohort with the purpose of evaluating the accuracy of a combination technique in SLNB. METHOD:All melanoma patients who underwent SLNB surgery by the senior author at Cleveland Clinic in February 2011 to December 2021 were included. All patients underwent SLNB using a combination of gamma and ICG for SLN identification. RESULTS:1,000 patients with mean age of 61 met the inclusion criteria. 220 patients had a positive SLNB with a mean number of 1.25 positive nodes of from an average of 2.86 nodes removed. From the 277 positive nodes, 247 (90%) were identified using combination of gamma and ICG (n=180/220), 21 (7%) using Gamma only (n= 26/ 220) and 8 (2%) using ICG only (n=14/220). 470 had a negative SLNB with an average of 2.9 nodes removed and a FNR of 2.3%. Mean follow-up was 2.3 years. CONCLUSION:We report one of the lowest false negative rates in a large patient cohort using a combination technique of gamma and ICG in SLNB, proving it a reliable technique in detecting melanoma nodal involvement.