Abstract
BACKGROUND: Surgical intervention, particularly sentinel lymph node and lymph node dissection, is essential in managing melanoma, targeting locoregional disease. Our aim was to elucidate risk factors for postoperative lymphatic complications in melanoma patients undergoing lymph node surgery in Peru. METHODS: A retrospective cohort study was conducted, reviewing records of melanoma patients who underwent lymphatic surgery at the Instituto Nacional de Enfermedades Neoplásicas from 2010 to 2019. Descriptive statistics and logistic regression analyses were performed to identify predictors of lymphatic complications. RESULTS: The study included 699 melanoma patients (mean age 60.70 y, 51.4% women). Most patients were Hispanic (99.3%) and from Lima (52.8%), with lower extremity involvement being common. Surgical interventions included wide local excision (56.9%), sentinel lymph node surgery (67%), and lymph node dissection (32.3%). Complications at the site of lymph node dissection included wound dehiscence (1.6%), infection (6.2%), lymphoceles (5.7%), and lymphedema (2.7%). Multivariate analysis identified lymphatic invasion (odds ratio [OR] = 2.601, 95% confidence interval [CI]: 1.232-5.491) and positive lymph node pathology (OR = 2.066, 95% CI: 1.034-4.127) as risk factors, whereas primary lesion location in the upper extremity (OR = 0.055, 95% CI: 0.007-0.408) and trunk (OR = 0.106, 95% CI: 0.014-0.818) were protective factors. CONCLUSIONS: Key risk factors for postoperative lymphatic complications in melanoma patients undergoing lymph node surgery include lower extremity involvement, lymph node dissections, lymphatic invasion, and positive lymph nodes. Understanding these risk factors can help clinicians optimize management strategies to reduce postoperative lymphatic complications.