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Complications of sentinel lymph node biopsy for melanoma - A systematic review of the literature

Moody JA, Ali RF, Carbone AC, Singh S, Hardwicke JT

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 2017

9,047 participants

Abstract

PURPOSE: The complications reported after sentinel lymph node biopsy (SLNB) for melanoma is highly variable in the worldwide literature; the overall complication rate varies between 1.8% and 29.9%. With heterogeneous reporting of morbidity data, no 'average' complication rates of this procedure have been reported. This systematic review aims to determine the complications rates associated with SLNB.

METHODS: A systematic review of English-language literature from 2000 to 2015, which reported morbidity information about SLNB for melanoma, was performed. The methodological quality of the included studies was performed using the methodological index for non-randomised studies (MINORS) instrument and Detsky score. Pooled proportions of specific post-operative complications were constructed using a random effects statistical model, and subgroups including lymph node basin and continent of origin of the study were compared.

RESULTS: After application of inclusion and exclusion criteria, 21 articles progressed to the final analysis. 9047 patients were included. The overall complication rate was 11.3% (95% CI: 8.1-15.0). The incidence of infection was 2.9% (95% CI 1.5-4.6); seroma 5.1% (95% CI: 2.5-8.6); haematoma 0.5% (95% CI: 0.3-0.9) lymphoedema 1.3% (95% CI: 0.5-2.6) and nerve injury 0.3% (95% CI: 0.1-0.6). There was no statistically significant difference in morbidity between the sites of SLNB or between continents.

DISCUSSION: This study provides information about the…

How strong is the evidence?

Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 9,047 participants or records.

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