Oral Presentation NZ Association of Plastic Surgeons & NZ Society for Surgery of the Hand

Inguinal lymphadenectomy related complications in a tertiary New Zealand centre: Change in approach? Are we doing right by our patients?  (1478)

Jia Hui JH Lim 1 , Niki N Kau 1 , Eric E Tan 1
  1. Waikato Hospital, Hamilton Lake, WAIKATO, New Zealand

Background: 

Inguinal lymphadenectomy (IL) is a recognised surgical procedure being used as part of locoregional control for certain advanced cutaneous cancers. It is a relatively morbid procedure that confers no expected survival benefits. 

We would like to investigate the complication rate and clinical outcomes in our IL cohort in comparison to other published data in literature. 

  

Methods: 

Retrospective case study of all IL performed by Plastic Surgery Waikato Hospital from January 2010 to May 2022. All cases were identified through electronic theatre records. Standard proforma was used for data gathering and analysis. 

Two published articles from South Korea and Netherlands were used for comparison. 

  

Result: 

56 patients were included in study with following demographics: mean age 68 +/- 4 years, almost equal distribution in gender, mean BMI 28. Only 3 were smokers.  

Our cohort is more morbid compared to reference literature based on Korean cohort (chi-squared p=0.0003). 

46 patients (82%) had macroscopic disease at the time of IL. 46 cases were for melanoma, with remaining due to squamous cell carcinoma and sarcoma. 

Mean follow-up was 603 +/- 162 days in 56 patients.  

Complication rate was 66.1% (chi-squared p=0.0004 compared to literature group). 6 patients had more than one complication.  

Local recurrence rate was 2% (1/56 patients).  

Mean time from IL to recurrence was 394 +/- 127 days in 18 patients. 

Mean time from IL to death was 859 +/- 249 days in 32 patients. Progression free survival was 327 +/- 212 days. 

  

Conclusion: 

Our patients have higher BMI status with majority presented with macroscopic regional disease compared to other units worldwide, which may explain the higher complication rate after IL. However, IL provides good regional control in our patient group. 

Local data/performance profile should be used as part of enhanced informed consent process for consideration of patients for IL.   

 

  1. Lee, I. A., Kim, H. J., Kim, E., Lee, J. Y., Lee, J., Lee, J. G., Lee, C.-kun, Shin, S. J., Chung, K. Y., & Kim, M. S. (2020). Complications and outcomes following inguinal lymphadenectomy for malignant melanoma in an Asian population. Korean Journal of Clinical Oncology, 16(2), 71–78. https://doi.org/10.14216/kjco.20012
  2. Faut, M., Heidema, R. M., Hoekstra, H. J., van Ginkel, R. J., Been, S. L., Kruijff, S., & van Leeuwen, B. L. (2016). Morbidity after inguinal lymph node dissections: It is time for a change. Annals of Surgical Oncology, 24(2), 330–339. https://doi.org/10.1245/s10434-016-5461-3