Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2013

01-06-2013 | Melanomas

Wound Complications after Inguinal Lymph Node Dissection for Melanoma: Is ACS NSQIP Adequate?

Authors: Carly E. Glarner, MD, David Y. Greenblatt, MD, MSPH, Robert J. Rettammel, MA, Heather B. Neuman, MD, MPH, Sharon M. Weber, MD, FACS

Published in: Annals of Surgical Oncology | Issue 6/2013

Login to get access

Abstract

Background

In the treatment of melanoma, inguinal lymph node dissection (ILND) is the standard of care for palpable or biopsy-proven lymph node metastases. Wound complications occur frequently after ILND. In the current study, the multicenter American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) was utilized to examine the frequency and predictors of wound complications after ILND.

Methods

Patients with cutaneous melanoma who underwent superficial and superficial with deep ILND from 2005-2010 were selected from the ACS NSQIP database. Standard ACS NSQIP 30-day outcome variables for wound occurrences—superficial surgical site infection (SSI), deep SSI, organ space SSI, and disruption—were defined as wound complications.

Results

Of 281 total patients, only 14 % of patients had wound complications, a rate much lower than those reported in previous single institution studies. In a multivariable model, superficial with deep ILND, obesity, and diabetes were significantly associated with wound complications. There was no difference in the rate of reoperation in patients with and without wound complications.

Conclusions

ACS NSQIP appears to markedly underreport the actual incidence of wound complications after ILND. This may reflect the program’s narrow definition of wound occurrences, which does not include seroma, hematoma, lymph leak, and skin necrosis. Future iterations of the ACS NSQIP for Oncology and procedure-specific modules should expand the definition of wound occurrences to incorporate these clinically relevant complications.
Literature
1.
Howlader N NA, Krapcho M, Neyman N, Aminou R, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review. Bethesda, MD: National Cancer Institute, 1975-2009 (Vintage 2009 Populations).
2.
Chang SB, Askew RL, Xing Y, et al. Prospective assessment of postoperative complications and associated costs following inguinal lymph node dissection (ILND) in melanoma patients. Ann Surg Oncol. 2010;17(10):2764-72.PubMedCrossRef
3.
Coit DG, Rogatko A, Brennan MF. Prognostic factors in patients with melanoma metastatic to axillary or inguinal lymph nodes: a multivariate analysis. Ann Surg. 1991;214(5):627-36.PubMedCrossRef
4.
Serpell JW, Carne PW, Bailey M. Radical lymph node dissection for melanoma. ANZ J Surg. 2003;73(5):294-9.PubMedCrossRef
5.
6.
7.
Guggenheim MM, Hug U, Jung FJ, et al. Morbidity and recurrence after completion lymph node dissection following sentinel lymph node biopsy in cutaneous malignant melanoma. Ann Surg. 2008;247(4):687-93.PubMedCrossRef
8.
de Vries M, Vonkeman WG, van Ginkel RJ, et al. Morbidity after inguinal sentinel lymph node biopsy and completion lymph node dissection in patients with cutaneous melanoma. Eur J Surg Oncol. 2006;32(7):785-9.PubMedCrossRef
9.
Hughes TM, A’Hern RP, Thomas JM. Prognosis and surgical management of patients with palpable inguinal lymph node metastases from melanoma. Br J Surg. 2000;87(7):892-901.PubMedCrossRef
10.
11.
Beitsch P, Balch C. Operative morbidity and risk factor assessment in melanoma patients undergoing inguinal lymph node dissection. Am J Surg. 1992;164(5):462-5; discussion 465-6.PubMedCrossRef
12.
Shaw JH, Rumball EM. Complications and local recurrence following lymphadenectomy. Br J Surg. 1990;77(7):760-4.PubMedCrossRef
13.
Poos HP, Kruijff S, Bastiaannet E, et al. Therapeutic groin dissection for melanoma: risk factors for short term morbidity. Eur J Surg Oncol. 2009;35(8):877-83.PubMedCrossRef
14.
Sabel MS, Griffith KA, Arora A, et al. Inguinal node dissection for melanoma in the era of sentinel lymph node biopsy. Surgery. 2007;141(6):728-35.PubMedCrossRef
Metadata
Title
Wound Complications after Inguinal Lymph Node Dissection for Melanoma: Is ACS NSQIP Adequate?
Authors
Carly E. Glarner, MD
David Y. Greenblatt, MD, MSPH
Robert J. Rettammel, MA
Heather B. Neuman, MD, MPH
Sharon M. Weber, MD, FACS
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2856-7

Other articles of this Issue 6/2013

Annals of Surgical Oncology 6/2013 Go to the issue

Thoracic Oncology

Predictive Factors of Lymph Node Status in Small Peripheral Non-small Cell Lung Cancers: Tumor Histology is More Reliable

Colorectal Cancer

Long-term Results of Rectal Cancer Surgery with a Systematical Operative Approach

Urologic Oncology

Effect of Nodal Metastases on Cancer-specific Mortality After Cytoreductive Nephrectomy

Breast Oncology

Variation in the Utilization of Reconstruction Following Mastectomy in Elderly Women

Breast Oncology

Breast Cancer Subtype and Distant Recurrence after Ipsilateral Breast Tumor Recurrence

Healthcare Policy and Outcomes

Longitudinal Changes in Function, Symptom Burden, and Quality of Life in Patients with Early-Stage Lung Cancer