METHODS: A retrospective review of prospectively collected, clinically node-negative patients undergoing ASLNB for melanoma at a single institution during a 14-year period was conducted to determine the incidence of AWS. Features pertaining to patients (age and gender), primary tumor (location, Breslow\'s depth), and nodes (number removed, positive node rate) were correlated with the occurrence of AWS.
RESULTS: Of the 465 patients undergoing ASLNB, 21 (4.5%) developed AWS postoperatively. In comparison, the incidence of other complications in this population were infection 3%, bleeding 1.5%, wound dehiscence .8%, lymphocele 5%, and lymphedema .4%. There was no statistical difference between patients with or without AWS in terms of tumor thickness, location of primary (upper extremity vs trunk), average number of sentinel nodes removed, positive SLNB rates (10% vs 12%), patient age, or gender. All cases of AWS resolved with expectant management; none required surgical intervention.
CONCLUSIONS: AWS is a notable complication of ASLNB for melanoma, with an incidence as high or higher than \"standard\" complications. AWS should, therefore, be included in the preoperative discussion of possible complications of ASLNB. Traditional patient, tumor, and nodal factors are not predictive of AWS. Patients should be counseled that AWS usually responds to symptomatic treatment and resolves with time.
方法:对前瞻性收集的,在14年期间,我们对在一家机构接受黑色素瘤ASLNB治疗的临床淋巴结阴性患者进行了研究,以确定AWS的发病率.与患者有关的特征(年龄和性别),原发性肿瘤(位置,Breslow\的深度),和节点(删除了数字,阳性节率)与AWS的发生相关。
结果:在接受ASLNB的465名患者中,21人(4.5%)在术后发展AWS。相比之下,该人群中其他并发症的发生率为感染3%,出血1.5%,伤口开裂。8%,淋巴结肿大5%,和淋巴水肿.有或没有AWS的患者在肿瘤厚度方面没有统计学差异,主要位置(上肢vs躯干),平均去除的前哨节点数,SLNB阳性率(10%对12%),患者年龄,或性别。所有AWS病例均通过预期管理解决;没有需要手术干预。
结论:AWS是黑色素瘤患者ASLNB的显著并发症,发病率高于或高于“标准”并发症。AWS应该,因此,术前讨论ASLNB可能的并发症。传统患者,肿瘤,节点因素不能预测AWS。应告知患者AWS通常对对症治疗有反应,并随时间解决。