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Complications Associated With Sentinel Lymph Node Biopsy for Melanoma

From the Division of Surgical Oncology, Department of Surgery, University of Louisville, James Graham Brown Cancer Center, and Center for Advanced Surgical Technology of Norton Hospital, Louisville, Kentucky (WRW, SLW, MJE, CC, VV, KMM); Department of Mathematics, University of Louisville, Louisville, Kentucky (PBC); University of South Florida, Moffitt Cancer Center, Tampa, Florida (DSR); University of Texas, M. D. Anderson Cancer Center, Houston, Texas (MIR); and LDS Hospital, Salt Lake City, Utah (RDN).

Correspondence: Address correspondence and reprint requests to: Kelly M. McMasters, MD, PhD, University of Louisville, J. Graham Brown Cancer Center, 529 S. Jackson Street, Louisville, KY 40202; Fax: 502-629-3379; E-mail: kelly.mcmasters{at}nortonhealthcare.org

Background: Sentinel lymph node (SLN) biopsy has become widely accepted as a method of staging the regional lymph nodes for patients with melanoma. Although it is often stated that SLN biopsy is a minimally invasive procedure associated with few complications, a paucity of data exists to specifically determine the morbidity associated with this procedure. This analysis was performed to evaluate the morbidity associated with SLN biopsy compared with completion lymph node dissection (CLND).

Methods: Patients were enrolled in the Sunbelt Melanoma Trial, a prospective multi-institutional study of SLN biopsy for melanoma. Patients underwent SLN biopsy and were prospectively followed up for the development of complications associated with this technique. Patients who had evidence of nodal metastasis in the SLN underwent CLND. Complications associated with SLN biopsy alone were compared with those associated with SLN biopsy plus CLND.

Results: A total of 2120 patients were evaluated, with a median follow-up of 16 months. Overall, 96 (4.6%) of 2120 patients developed major or minor complications associated with SLN biopsy, whereas 103 (23.2%) of 444 patients experienced complications associated with SLN biopsy plus CLND. There were no deaths associated with either procedure.

Conclusions: SLN biopsy alone is associated with significantly less morbidity compared with SLN biopsy plus CLND.

Key Words: Melanoma • Sentinel lymph node • Morbidity • Complications • Lymph node dissection

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