Abstract

We aimed to elucidate morbidity following videoscopic inguinal lymphadenectomy for stage III melanoma. Melanoma patients who underwent a videoscopic inguinal lymphadenectomy between November 2015 and May 2019 were included. The measured outcomes were lymphedema and quality of life. Patients were reviewed one day prior to surgery and postoperatively every 3 months for one year. A total number of 34 patients were included for participation; 19 (55.9%) patients underwent a concomitant iliac lymphadenectomy. Lymphedema incidence was 40% at 3 months and 50% at 12 months after surgery. Mean interlimb volume difference increased steadily from 1.8% at baseline to 6.9% at 12 months (p = 0.041). Median Lymph-ICF-LL total score increased from 0.0 at baseline to 12.0 at 3 months, and declined to 8.5 at 12 months (p = 0.007). Twelve months after surgery, Lymph-ICF-LL scores were higher for females (p = 0.021) and patients that received adjuvant radiotherapy (p = 0.013). The Median Distress Thermometer and EORTC QLQ-C30 summary score recovered to baseline at 12 months postoperatively (p = 0.747 and p = 0.203, respectively). The onset of lymphedema is rapid and continues to increase up to one year after videoscopic inguinal lymphadenectomy. Quality of life recovers to the baseline value.

Highlights

  • Cutaneous melanoma is a potentially life-threatening disease, and the incidence is increasing rapidly across the globe [1]

  • We reported a lymphedema incidence of 40% at 3 months and 50% at 12 months following Videoscopic inguinal lymphadenectomy (VIL)

  • The interlimb volume difference increased to approximately 7% at 12 months after VIL, a phenomenon noted in previous research regarding Open inguinal lymphadenectomy (OIL) [23]

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Summary

Introduction

Cutaneous melanoma is a potentially life-threatening disease, and the incidence is increasing rapidly across the globe [1]. Melanoma of the lower extremity and lower trunk can spread to draining lymph nodes in the groin. Lymph node status is a powerful predictor of recurrence and survival [2]. Inguinal Lymphadenectomy (IL) consists of the en bloc resection of fibrofatty tissue within the femoral triangle and has long been the standard of care for regionally metastatic melanoma. Treatment for inguinal metastatic melanoma is currently changing. Routine completion IL does not improve overall or melanoma-specific survival and is, no longer warranted. A therapeutic IL remains part of the treatment options for clinically detected nodal metastases [3,4]

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