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| |  Lymphoedema After Lower Extremity Sentinel Node Biopsy Common in Patients With Melanoma: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 6, 2010 -- Lymphoedema after inguinal sentinel node biopsy (SNB) is more common than previously reported, investigators announced here on March 5 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO). In fact, lymphoedema occurred in nearly half of patients in their series. Patrick Magoon, Tufts University School of Medicine, Boston, Massachusetts, presented the results of a chart review of all patients who underwent SNB for melanoma at Tufts Medical Center over a recent 7-year period. “For melanoma patients, the benefits of SNB in the staging of regional lymph nodes have been confirmed by an abundance of data demonstrating its prognostic efficacy,” Magoon noted. “Additionally, SNB has been shown to be far less morbid than its predecessor -- the elective lymph node dissection. Thus, there is a widespread notion that SNB is minimally invasive.” However, the specific risks associated with SNB, particularly lymphoedema, have not been adequately examined, and lymphoedema is a potentially permanent side effect that can have serious have serious implications for quality of life,” he said. “Insight into the occurrence of lymphoedema and risk factors leading to its development may lead to further reductions in complications associated with SNB.” Results showed that 18 of 40 patients, or 45%, experienced postoperative lymphoedema. The swelling was described as minimal by 3 patients, mild by 14, and severe by 1 patient. Most patients (67%) experienced lymphoedema within 1 month after surgery, and lymphoedema persisted for at least 12 months in half of patients. Daily support stocking use was needed by 6 patients and occasional use was needed by 4 patients. Two patients cited functional limitations in their daily lives as a result of swelling. Two risk factors were found to be significantly associated with the onset of lymphoedema: primary tumours located on the lower leg and foot and choice of surgeon/surgical technique. Magoon said that the 45% lymphoedema incidence following an inguinal SNB occurring in this study represents a significant increase over that found in previous reports. He was quick to add, however, that lower extremity lymphoedema has been “incompletely studied” and its true incidence needs to be determined. Because the choice of surgeon and surgical technique appears to be a risk factor for lymphoedema, surgeons should consider re-evaluating their technique for SNB, Magoon advised. [Presentation Title: Risk of Lymphedema Following Sentinel Node Biopsy (SNB) for Lower Extremity Melanoma. Abstract 253]
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