Persistent pain after surgery for cutaneous melanoma.

Area of Science:

• Oncology
• Plastic Surgery
• Pain Medicine

Background:

• Persistent postoperative pain is a recognized complication following various surgical procedures.
• The prevalence and specific predictors of chronic pain after melanoma surgery remain largely uncharacterized.

Purpose of the Study:

• To determine the prevalence of persistent pain after melanoma surgery.
• To identify predictors associated with persistent pain in this patient population.

Main Methods:

• A cohort of 448 patients undergoing cutaneous melanoma surgery between 2005 and 2009 was studied.
• 350 survivors (87.1%) completed a questionnaire assessing pain and sensory changes.
• Clinical examinations were conducted on a subset of patients with and without pain.

Main Results:

• 8.6% of patients reported chronic pain, with 3.4% experiencing at least moderate impact on daily life.
• Sensory changes were reported by 31.5% of patients, and 25% of these individuals experienced pain, compared to 3% with normal sensation (P<0.001).
• Younger age was identified as a predictor for persistent pain, which was also associated with abnormal sensation.

Conclusions:

• Persistent pain is a complication of melanoma surgery, consistent with findings in other surgical fields.
• Abnormal sensation in the surgical area is strongly related to persistent pain.
• Neuropathic pain mechanisms should be considered in patients experiencing persistent pain after melanoma surgery.