Lymph node dissection in patients with malignant melanoma is associated with high risk of morbidity

Malignant melanoma is one of the most rapidly increasing cancer types globally, and it is by far the most serious skin cancer. 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.

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. Fisher's exact test and Mann-Whitney U-test were used to evaluate associations.

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.

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.