Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;61(7):848-854.
doi: 10.1111/ijd.16056. Epub 2022 Jan 31.

Using the Merlin assay for reducing sentinel lymph node biopsy complications in melanoma: a retrospective cohort study

Tina J Hieken  1 , Mariana B Sadurní  2 , Enrica Quattrocchi  2 , Ajdin Kobic  2 , Sindhuja Sominidi-Damodaran  2 , Jvalini T Dwarkasing  3 , Lisette Meerstein-Kessel  3 , Alina G Bridges  4 , Alexander Meves  2
Affiliations

Using the Merlin assay for reducing sentinel lymph node biopsy complications in melanoma: a retrospective cohort study

Tina J Hieken et al. Int J Dermatol. 2022 Jul.

Abstract

Background: The assessment of the sentinel lymph node is a cornerstone of melanoma staging. However, ~80% of sentinel lymph node biopsies (SLNB) are negative and nontherapeutic, and patients are unnecessarily exposed to surgery-related complications. Here, we gauged the potential of the Merlin assay to reduce SLNB-associated complications. The Merlin assay uses clinicopathologic variables and tumor gene expression profiling to identify low-risk patients who may forgo SLNB.

Methods: We utilized the Merlin test development cohort to determine SLNB complication rates for procedures performed between 2004 and 2018 at Mayo Clinic. Complications evaluated were lymphedema, seroma, infection/cellulitis, hematoma, and wound dehiscence. Patients who underwent a completion lymph node dissection were excluded.

Results: A total of 558 patients were included. The overall 90-day complication rate specific to SLNB (1 year for lymphedema) was 17.4%. The most common complications were seroma (9.3%), infection/cellulitis (4.8%), and lymphedema (4.3%). All three were more common in patients with a lower extremity primary tumor location versus other locations. With Merlin test results applied, SLNB-related complications would have decreased by 59%.

Conclusion: SLNB is a safe procedure but carries a significant complication rate. Merlin testing might reduce the need for SLNB and its associated complications.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Time to complications after sentinel lymph node biopsy (SLNB). Data are visualized as box plots
Figure 2
Figure 2
Graphical summary of study results
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cancer stat facts: melanoma of the skin. National Cancer Institute: Surveillance, Epidemiology, and End Results P.... https://seer.cancer.gov/statfacts/html/melan.html (accessed 21 December 2020).
    1. Morton DL, Thompson JF, Cochran AJ, et al. Final trial report of sentinel‐node biopsy versus nodal observation in melanoma. N Engl J Med 2014; 370: 599–609. - PMC - PubMed
    1. National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Melanoma: Cutaneou. http://paperpile.com/b/MxWm0E/Pup0c1.2021. 25 November 2020.
    1. Gershenwald JE, Scolyer RA, Hess KR, et al. Melanoma staging: evidence‐based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin 2017; 67: 472–492. - PMC - PubMed
    1. Meves A, Eggermont AMM. Deselecting melanoma patients for sentinel lymph node biopsy during COVID‐19: clinical utility of tumor molecular profiling. Mayo Clin Proc Innov Qual Outcomes 2020; 4: 586–587. - PMC - PubMed

Substances