title: Sentinel lymph node biopsy with a gamma probe in patients with high-risk cutaneous squamous cell carcinoma:  follow-up results of sentinel lymph node-negative patients.
abstract: OBJECTIVE
  Lymphoscintigraphy (LS) and sentinel lymph node biopsy have become the standard of care for melanoma and breast cancer. However, the data on patients with cutaneous squamous cell carcinoma (SCC) are limited. We aimed to evaluate and identify the role of LS and sentinel lymph node biopsy in patients with high-risk cutaneous SCC.
  
  
  METHODS
  Nineteen patients (13 men, six women; 47-87 years of age, mean age 67.5 ± 12.3) with SCC were included in the study. LS was performed on all patients after intracutaneous injection of Tc-99m nanocolloid. Primary lesions and sentinel lymph nodes (SLNs) were excised with the help of a gamma probe.
  
  
  RESULTS
  A total of 26 SLNs and 32 secondary lymph nodes were imaged on LS and were marked. During surgery, 29 SLNs, 21 secondary lymph nodes and three nonactive lymph nodes were excised. In total, 53 lymph nodes were removed surgically. A histopathological study revealed that all lymph nodes were negative for metastasis. Patients were followed up for an average of 41.1 ± 22.2 months (7-80 months). Until the time of data collection, 14 patients were alive and had no regional lymph node or distant metastasis. Local recurrence was seen in only one patient. He was reoperated upon 38 months ago.
  
  
  CONCLUSIONS
  The feasibility of determining SLNs using LS and an intraoperative gamma probe in patients with cutaneous SCC was shown. Unnecessary elective lymph node dissection and possible complications could be avoided in 19 patients.
authors.affiliation: Departments of Nuclear Medicine, Kocaeli University School of Medicine, Umuttepe, Turkey. hakandemir99@yahoo.com
authors.forename: Hakan
authors.initials: H
authors.lastname: Demir
authors.forename: Tonguc
authors.initials: T
authors.lastname: Isken
authors.forename: Evrim
authors.initials: E
authors.lastname: Kus
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ziya Tan
authors.forename: Serkan
authors.initials: S
authors.lastname: Isgoren
authors.forename: Gozde
authors.initials: G
authors.lastname: Daglioz Gorur
authors.forename: Alper
authors.initials: A
authors.lastname: Oc
authors.forename: Cenk
authors.initials: C
authors.lastname: Sen
authors.forename: Deniz
authors.initials: D
authors.lastname: Cek
authors.forename: Cengiz
authors.initials: C
authors.lastname: Ercin
authors.forename: Fatma
authors.initials: F
authors.lastname: Berk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D015902:Gamma Cameras; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D061305:Lymphoscintigraphy / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods* / Q000592:standards; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid