Herlev University Hospital, Denmark
Title: Lymph node dissection in patients with malignant melanoma is associated with high risk of morbidity
Ul-Mulk finished his medical degree in 2007 from Copenhagen Medical University. He is now a third year resident in Plastic Surgery, Reconstruction and Burns at Copenhagen University Hospital. He has published several papers and at the moment & is doing a study about "Breast reconstruction in Denmark in the periode 2007-2011, the frequency and methods". His interests are Head and Neck Reconstruction, cranio-facial surgery and melanoma.
Introduction: Malignant melanoma is one of the most rapidly increasing cancer types globally. Patients with a melanoma 1 mm in Breslow thickness are offered sentinel node (SN) biopsy and subsequent radical lymph node dissection if the biopsy is positive. The objective in the present paper was to describe post-operative complications in this group of patients. A standard operation and drainage regime was used.
Materials and Methods: This was a retrospective study based on 96 consecutive SN-positive patients with primary cutaneous malignant melanoma who underwent subsequent radical axillary or inguinal lymph node dissection.
Results: In all, 57 patients were male and 39 female. A total of 71 had an axillary and 25 an inguinal operation. The median drainage period was seven days (2-15 days). Forty patients developed seroma which needed puncture; three of these cases were chronic, there was no difference between the two groups. Seroma puncture was only associated with infection in the inguinal group (p = 0.04). 25% in the axillary group were diagnosed with lymph oedema after three months versus 48% in the inguinal group (p = 0.04). A body mass index? 25 kg/m2 was associated with a slight, but non-significant increase in complications (p = 0.08). No association was found for smoking or co-morbidity.
Conclusion: Patients undergoing axillary or inguinal lymph node dissection experience a significant number of complications, especially seroma and lymph oedema. Long-term complications are severe and can profoundly impact the patient's quality of life.