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Perioperative neutrophil-to-lymphocyte ratio in patients with melanoma: a pilot study assessing surgical stress after sentinel lymph node biopsy

  • 0Department of Plastic and Breast Surgery, Aalborg University Hospital, Aalborg.
Melanoma Research +

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June 29, 2025

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June 29, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Even minor melanoma surgeries like wide local excision and sentinel lymph node biopsy cause significant surgical stress. The neutrophil-to-lymphocyte ratio (NLR) effectively indicates this stress response, showing a shift to moderate levels post-operation.

Area Of Science

  • Oncology
  • Immunology
  • Surgical Stress Response

Background

  • Surgical stress impacts oncologic outcomes, influencing complications, prognosis, and survival.
  • The neutrophil-to-lymphocyte ratio (NLR) is a key biomarker for inflammation and immune response, reflecting surgical stress.
  • The surgical stress response of minimally invasive melanoma procedures like wide local excision (WLE) and sentinel lymph node biopsy (SLNB) is not well understood.

Purpose Of The Study

  • To investigate perioperative changes in the neutrophil-to-lymphocyte ratio (NLR) as a marker of surgical stress in melanoma patients undergoing WLE and SLNB.
  • To assess the magnitude of surgical stress induced by these minimally invasive melanoma procedures.

Main Methods

  • Prospective pilot study involving 20 melanoma patients undergoing WLE and SLNB.
  • Neutrophil-to-lymphocyte ratio (NLR) measured preoperatively and at 2 and 6 hours postoperatively.
  • Statistical analysis using paired t-tests to compare NLR values across time points.

Main Results

  • Mean NLR increased significantly from 1.94 preoperatively to 9.5 at 2 hours (P < 0.001) and 16.04 at 6 hours (P = 0.02).
  • This NLR elevation indicates a shift from no systemic stress (NLR: 1-3) to a moderate (NLR: 8-18) stress response.
  • NLR changes were driven by neutrophilia and lymphocytopenia, despite the procedures being considered minimally invasive.

Conclusions

  • Wide local excision (WLE) and sentinel lymph node biopsy (SLNB) induce a substantial surgical stress response in melanoma patients.
  • The neutrophil-to-lymphocyte ratio (NLR) shows potential as a valuable biomarker for monitoring surgical stress in melanoma surgery.
  • Monitoring NLR may have implications for optimizing surgical and oncologic outcomes in melanoma management.

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