Background
Surgery is the most effective treatment for skin cancer with metastases to lymph node basins. Studies have shown an association between high lymph node (LN) count from lymphadenectomy, and overall improved survival. Recent studies have been published with guidelines and targets for lymph node counts. A retrospective study was designed to audit the outcome of lymphadenectomy and LN count in Christchurch hospital. The aim is to compare local results to published target outcomes.
Methods
A retrospective clinical note review was performed for all plastic surgery patients who had axillary, groin or head and neck (H&N) lymphadenectomy in Christchurch hospital in between 2012 and 2016. Demographics collected included type of operation, diagnosis, surgeon, levels of neck dissection and lymph node count.
Results
From 2012-2016, a total of 161 patients had 177 lymphadenectomy operations at the Canterbury Regional Plastics Unit. There were 69 axillary dissections, 50 groin dissections, and 58 H&N dissection. 111 lymphadenectomies for melanoma, 61 for SCC, and 5 for other cancers such as merkel cell and BCC. The average LN count for axillary dissection was 21, groin dissection 12.1, H&N (levels 3 or less) 19.9, H&N (levels 4 or more) 38.8.
Conclusions
The average LN count from lymphadenectomy at Canterbury Regional Plastics Unit correlates with the numbers quoted in current literature and therefore maintains the proposed quality standards for lymphadenectomies.