Occurrence of Lymphedema Following Sentinel Node Biopsy (SNB) for Lower Extremity Melanoma

Abstract

Background : The benefits of sentinel node biopsy for melanoma are well established, while the risks have received less attention. This study was undertaken to establish the incidence of lower extremity lymphedema following inguinal SNB and to identify risk factors predictive for the development of lymphedema. Methods: We conducted a retrospective chart review of all patients undergoing SNB at our institution between January 2000 and December 2007. Sixty-five patients were identified who had a lower extremity melanoma and underwent inguinal SNB in the absence of a completion lymph node dissection. After a minimum one year of follow-up, all patients were surveyed regarding their qualitative assessment of lymphedema. Results: Forty patients returned surveys and are the subject of this study. Fourteen of 40 patients (35%) reported experiencing post-operative lymphedema, with 9 patients (23%) having lymphedema that persisted for more than 1 year. The onset occurred within 1 month of surgery in 8 patients (25%). Lymphedema was described as minimal or mild by 13 patients and severe by 1 patient. Lymphedema requiring support stocking use was reported by 10 patients (25%). An increased incidence of post-operative lymphedema was found to be associated with primary tumors located on the lower leg or foot. Conclusions: Fourteen patients (35%) undergoing inguinal SNB experienced post-operative lymphedema, with 9 patients (23%) having persistent lymphedema for more than 1 year. These numbers are higher than in previously reported series. Location of the melanoma on the lower leg or foot appeared to be a significant risk factor. doi:10.4021/jcs33w