Utility of sentinel lymphadenectomy in the management of patients with high-risk cutaneous squamous cell carcinoma

Matthew J Reschly, Jane L Messina, Larissa L Zaulyanov, Wayne Cruse, Neil A Fenske
Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.] 2003, 29 (2): 135-40

BACKGROUND: High-risk cutaneous squamous cell carcinoma (SCC) is an aggressive tumor with a significant rate of metastasis, especially nodal, and deaths yearly. Sentinel lymphadenectomy may be a valuable adjunct in the treatment of patients with cutaneous SCC at high risk for metastases with a clinical N0 status.

OBJECTIVE: To report the clinical and pathologic features in nine patients who underwent this procedure at a tertiary-care cancer center.

METHODS: Since 1995, a total of nine patients from the Cutaneous Oncology Program at the H. Lee Moffitt Cancer Center received preoperative lymphoscintigraphy and sentinel lymphadenectomy for high-risk cutaneous SCC with a clinical N0 status.

RESULTS: Histologically positive nodes were found in 4 of 9 cases (44%). Two of the four patients with positive sentinel nodes died of metastatic disease within 2 years. All five patients with negative sentinel nodes are alive and well at a median follow-up of 8 months (mean of 13 months). Preoperative lymphoscintigraphy and sentinel lymphadenectomy were well tolerated by all patients.

CONCLUSION: In this small series of predominantly trunk and extremity high-risk SCCs, sentinel lymph node biopsy was technically feasible with low morbidity. Sentinel lymphadenectomy may prove to have an important role in the management of high-risk cutaneous SCC with a clinical N0 status.


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