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


CONCLUSIONS
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.
Reschly
Matthew J
MJ
Department of Internal Medicine, Division of Dermatology, University of South Florida College of Medicine, Tampa, Florida, USA.
Messina
Jane L
JL
Zaulyanov
Larissa L
LL
Cruse
Wayne
W
Fenske
Neil A
NA
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*