Sentinel-lymph-node biopsy (SLNB) for melanoma is not complication-free.
OBJECTIVE
Sentinel lymph node biopsy (SLNB) is reportedly associated with insignificant morbidity. The study aims at documenting SLNB-related complications and identifying possible risk factors.


METHODS
Data of all melanoma patients who underwent SLNB in our medical center (1994-2002) were analysed. Procedure-related complications were recorded.


RESULTS
Three hundred and nine lymphatic basins of 250 patients were explored for SLNB. Overall complication rate was 20%. Sensory morbidity was significantly associated with axillary SLNB (p=0.04) and was more prevalent in younger patients. The use of blue dye alone or combined with a hand-held gamma probe had no statistically significant impact on the identification rate. There were six false-negatives (2.3%), for an overall false-negative rate of 18%. A positive sentinel node was significantly associated with shortened overall survival (p=0.04).


CONCLUSIONS
Wound complications are more frequent than usually reported. Sensory morbidity occurs mostly in the axilla. Neck SLNB is associated with the highest rate of identification failure. Patient age, basin location, and number of excised nodes may serve as prognostic factors of morbidity.
Wasserberg
N
N
Department of Surgery B, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 49100 and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Tulchinsky
H
H
Schachter
J
J
Feinmesser
M
M
Gutman
H
H
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012678:Sensation Disorders / Q000175:diagnosis / Q000453:epidemiology; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects* / Q000379:methods; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013530:Surgical Wound Infection / Q000453:epidemiology; D016019:Survival Analysis