[Lymphatic mapping and sentinel lymph node biopsy in patients with high risk squamous cell carcinoma of the skin]

Jaime Alonso Reséndiz-Colosia, Adriana Abigail Valenzuela-Flores, Guadalupe Torres-Nuñez, Alma Gabriela Valenzuela-Flores, Rutilio Flores-Díaz, Francisco José Gallegos-Hernández, Sergio Arturo Rodríguez-Cuevas
Gaceta Médica de México 2007, 143 (3): 209-14

BACKGROUND: Some sub-groups of cutaneous squamous cell carcinoma (CSCC) display a higher risk for regional metastasis. Sentinel lymph node staging has been used successfully to evaluate nodal metastasis in selective tumors.

OBJECTIVE: Assess the feasibility of sentinel node to detect occult regional lymph node metastasis in high-risk CSCC.

MATERIAL AND METHODS: Between January 2002 and March 2004, a total of 20 patients received pre-operative lymphoscintigraphy and sentinel lymphadenectomy for high-risk CSCC with clinically non-palpable regional lymph nodes.

RESULTS: In one of each 5 patients (20%), sentinel lymph node showed histological evidence of microinvolvement. No patients with negative sentinel node showed tumor dissemination during follow-up, with a mean of 23.5 months (range 7-44).

CONCLUSIONS: Sentinel lymph node biopsy is technically feasible with low morbidity. Sentinel lymphadenectomy may play an important role in the management of high-risk CSCC with clinically non-palpable regional lymph nodes. This technique can help identify patients with regional lymph node metastases who may benefit from complete lymphadenectomy. This improved staging may allow clinicians to better stratify patients who might benefit from adjuvant therapy.

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