Complications and local recurrence following lymphadenectomy

Abstract

We have retrospectively reviewed the case notes of 208 patients undergoing either cervical, axillary, or inguinal lymphadenectomy with a view to determining the factors that predispose to complications and local recurrence. The most frequent complications were wound infection, seroma formation, paraesthesiae and lymphoedema. The main predisposing factor for complications was anatomical site; wound complications occur with twice the frequency in the inguinal lymphadenectomy group than in the two other sites. Preresection biopsy was also associated with an almost twofold increase in complications, while fine needle aspiration cytology was not. The two major factors influencing the incidence of local recurrence were the stage of the disease process and the use of preresection biopsy. There was a steady increase in the incidence of local recurrence with increasing stage of regional disease. In addition, local recurrence was almost twice as common in patients who had undergone biopsy before resection when compared with patients who either did not have tissue sampling before resection or had fine needle aspiration cytology alone. We conclude that fine needle aspiration cytology is safe and the investigation of choice in patients undergoing lymphadenectomy. In contrast, preresection biopsy should be avoided as it promotes both complications and local recurrence. In addition, wound complications and lymphoedema are frequent following lymphadenectomy, especially following inguinal dissection.