Background: Sentinel lymph node biopsy (SLNB) is a useful adjunct procedure in the staging and management of cutaneous melanoma. We aimed to present a comprehensive review of over a decade’s experience with SLNB at our regional centre in Canterbury, New Zealand.
Methods: We conducted a retrospective analysis of patients undergoing SLNB for melanoma at our institution from January 2011 to December 2023. This included data on patient demographics, primary melanoma characteristics, details of the SLNB procedure, and resultant complications.
Results: A total of 477 patients underwent SLNB, predominantly males (59.5%), the mean age was 58.6 years. Melanomas were most frequently located on the trunk (30.8%). Patent blue dye demonstrated better node visualization compared to methylene blue (87.7% vs 67.8%, p<0.05). Complication rates included seroma formation in 2.4% of axillary and 12.5% of groin biopsies. Lymphedema occurred in 3% of cases. The rates of hematoma and infection were within expected limits at 1%. The overall complication rate did not change over time. Following the results of the MSLT-2 trial, the rate of completion lymphadenectomy decreased from 94% (31 out of 33 patients) to 15% (8 out of 54 patients).
Conclusion: We provide an overview of our experience with this procedure at our unit. Our complication profile is within expected limits. Using patent blue dye results in increased visualisation of the SLN compared to Methylene blue. We have adjusted both the SLNB procedure and post operative management of our patients as new evidence has emerged.