%0 Journal Article
%T Postoperative Complications following Nodal Dissection and Their Association with Melanoma Recurrence
%A Abubakr Ahmed
%A Gaitri Sadadcharam
%A Felicity Huisma
%A Katrina Fogarty
%A Muhammad Mushtaque
%A Azher Shafiq
%A Paul Redmond
%J ISRN Surgery
%D 2013
%R 10.1155/2013/382138
%X Background. Although postoperative complications are common after lymph node dissection, its association with disease recurrence has not yet been fully investigated. Methods. A retrospective review of a prospectively maintained database was conducted, looking at all malignant melanoma patients with sentinel nodes positive disease requiring axillary or inguinal dissection between 2002 and 2011. Results. A total of 124 patients required nodal clearance from 317 patients with stage I/II malignant melanoma who had undergone sentinel lymph node biopsy. Of these, 104 patients met the inclusion criteria and were divided into inguinal lymph node dissections (ILND; ) or axillary lymph node dissections (ALND; ). Immunohistochemical deposits had higher detection rate in ALND ( ). The ILND patients had a higher recurrence rate (84.1% versus 63.4%; ) and mortality (68.3% versus 48.8%; ) without a significant difference in complications. In patients whom complications developed, 75% of the ILND group and 71.4% of the ALND group had disease recurrence, but without reaching a statistical value as an independent predictor of melanoma recurrence. Conclusion. Complications are common following ILND and ALND; however there is no significant difference in complications rates between the groups with some associations with recurrence without reaching a significant difference. 1. Introduction Malignant melanoma has a unique position in the surgical and oncological fields as it is responsible for 79% of mortalities despite representing less than 5% of cutaneous malignancies [1]. The considerable variation in recurrence and survival rates among melanoma patients has motivated many researchers to look at different variables and risk factors that could predict prognosis. Morton et al. revolutionised the management of malignant melanomas in early 1990s by developing the sentinel lymph node biopsy (SLNB) technique, an important landmark in the management of clinical stage I and II cutaneous melanoma [2]. As a result, the Multicentre Selective Lymphadenectomy Trial (MSLT) was initiated [3]. This trial has shown that the presence of metastases in the sentinel node was the most important prognostic factor and has recommended completion lymph node dissection for patients with a positive SLNB [3]. There are several histopathological features that predict recurrence and survival, including the Breslow¡¯s thickness, the presence of ulceration, and the mitotic rate [4]. Age, sex, presence of lymphovascular invasion and SLN status are other recognised risk factors [5]. The impact of the
%U http://www.hindawi.com/journals/isrn.surgery/2013/382138/