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. 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.

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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

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

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