Cutaneous Squamous Cell Carcinoma Tumour Size is Associated with Sentinel Lymph Node Metastasis in a Cohort of 69 Patients

Chabrillac, Emilien; Lusque, Amélie; Cavallier, Z.; Lopez, R.; Filleron, Thomas; Sarini, J.; Meyer, Nicolas; Vergez, S.

doi:10.2340/00015555-3293

Cited by 7 publications

(5 citation statements)

References 28 publications

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“…After inclusion criteria were applied, the full text of 310 articles were assessed. Of these, 129 studies were included in final analysis (Figure 1). Study characteristics, including risk of bias, are described in eTable 1 in the Supplement.…”

Section: Resultsmentioning

confidence: 99%

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Association of Patient Risk Factors, Tumor Characteristics, and Treatment Modality With Poor Outcomes in Primary Cutaneous Squamous Cell Carcinoma

et al. 2023

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ImportancePrimary cutaneous squamous cell carcinoma is usually curable; however, a subset of patients develops poor outcomes, including local recurrence, nodal metastasis, distant metastasis, and disease-specific death.ObjectivesTo evaluate all evidence-based reports of patient risk factors and tumor characteristics associated with poor outcomes in primary cutaneous squamous cell carcinoma and to identify treatment modalities that minimize poor outcomes.Data SourcesPubMed, Embase, and SCOPUS databases were searched for studies of the topic in humans, published in the English language, from database inception through February 8, 2022.Study SelectionTwo authors independently screened the identified articles and included those that were original research with a sample size of 10 patients or more and that assessed risk factors and/or treatment modalities associated with poor outcomes among patients with primary cutaneous squamous cell carcinoma.Data Extraction and SynthesisData extraction was performed by a single author, per international guidelines. The search terms, study objectives, and protocol methods were defined before study initiation. A total of 310 studies were included for full-text assessment. Owing to heterogeneity of the included studies, a random-effects model was used. Data analyses were performed from May 25 to September 15, 2022.Main Outcomes and MeasuresFor studies of risk factors, risk ratios and incidence proportions; and for treatment studies, incidence proportions.ResultsIn all, 129 studies and a total of 137 449 patients with primary cutaneous squamous cell carcinoma and 126 553 tumors were included in the meta-analysis. Several patient risk factors and tumor characteristics were associated with local recurrence, nodal metastasis, distant metastasis, disease-specific death, and all-cause death were identified. Among all factors reported by more than 1 study, the highest risks for local recurrence and disease-specific death were associated with tumor invasion beyond subcutaneous fat (risk ratio, 9.1 [95% CI, 2.8-29.2] and 10.4 [95% CI, 3.0- 36.3], respectively), and the highest risk of any metastasis was associated with perineural invasion (risk ratio, 5.0; 95% CI, 2.3-11.1). Patients who received Mohs micrographic surgery had the lowest incidence of nearly all poor outcomes; however, in some results, the 95% CIs overlapped with those of other treatment modalities.Conclusions and RelevanceThis meta-analysis identified the prognostic value of several risk factors and the effectiveness of the available treatment modalities. These findings carry important implications for the prognostication, workup, treatment, and follow-up of patients with primary cutaneous squamous cell carcinoma.Trial RegistrationPROSPERO Identifier: CRD42022311250

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Section: Resultsmentioning

confidence: 99%

“…Of these 129 studies, 114 studies assessed risk factors, with a total of 137 449 patients and 126 553 tumors. Of these, 87 studies with 122 484 tumors were included in the random effects analysis risk ratio, and 62 studies with 116 958 tumors were included in analysis of incidence data. Treatment modality was assessed by 28 studies…”

Section: Resultsmentioning

confidence: 99%

Association of Patient Risk Factors, Tumor Characteristics, and Treatment Modality With Poor Outcomes in Primary Cutaneous Squamous Cell Carcinoma

et al. 2023

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“…Previous studies evaluated the risk factors associated with positivity of SLNB results, but the findings differed among the studies, presumably because of the heterogeneity of the surgical indication for SLNB. The overall positive rate and false-negative rate in most of the previous studies were 5.4–14.6% and 0–5.7%, respectively [ 59 , 60 ]. Chabrillac et al reported that factors significantly associated with increased positivity of SLNB results were tumor size and poor tumor differentiation [ 59 ].…”

Section: Role Of Slnb In Skin Cancermentioning

confidence: 99%

“…The overall positive rate and false-negative rate in most of the previous studies were 5.4–14.6% and 0–5.7%, respectively [ 59 , 60 ]. Chabrillac et al reported that factors significantly associated with increased positivity of SLNB results were tumor size and poor tumor differentiation [ 59 ]. Another study showed that a tumor diameter ≥ 2 cm, tumor depth > 6 mm, or invasion into the subcutaneous fat, perineural invasion of nerves with a diameter ≥ 1 mm, moderate or poor histologic differentiation, lymphovascular invasion, and immunosuppression were associated with positive SLNB results [ 60 ].…”

Section: Role Of Slnb In Skin Cancermentioning

confidence: 99%

Role of Sentinel Lymph Node Biopsy for Skin Cancer Based on Clinical Studies

Ishizuki

Nakamura

2023

Cancers

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The sentinel lymph node is the first lymph node from the primary tumor. Sentinel lymph node biopsy (SLNB) is a surgical procedure that can detect occult nodal metastasis with relatively low morbidity. It may also have a therapeutic effect via regional disease control. The Multicenter Selective Lymphadenectomy-I (MSLT-I) trial revealed a prognostic benefit from SLNB in melanoma patients. However, it remains unclear whether there is a prognostic benefit from SLNB in patients with nonmelanoma skin cancer owing to a lack of randomized prospective studies. Nevertheless, SLNB provides important information about nodal status, which is one of the strongest factors to predict prognosis and may guide additional nodal treatment. Currently, SLNB is widely used in the management of not only patients with melanoma but also those with nonmelanoma skin cancer. However, the utilization and outcomes of SLNB differ among skin cancers. In addition, SLNB is not recommended for routine use in all patients with skin cancer. In this review, we provide a summary of the role of SLNB and of the indications for SLNB in each skin cancer based on previously published articles.

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“…[7][8][9] There is a growing body of literature related to sentinel lymph node biopsy (SLNB) as a staging technique for highrisk cSCC. [10][11][12][13][14] Although most of these studies are retrospective and often report a mix of primary and recurrent tumors, they have provided valuable hypothesisgenerating data. However, additional research is needed to understand the optimal patient cohort for consideration of SLNB and the impact of SLNB results on cSCC outcomes.…”

mentioning

confidence: 99%

Outcomes of Sentinel Lymph Node Biopsy for Primary Cutaneous Squamous Cell Carcinoma of the Head and Neck

Pride¹,

Lopez²,

Brewer³

et al. 2021

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BACKGROUND Limited data exist on sentinel lymph node biopsy (SLNB) for cutaneous squamous cell carcinoma (cSCC) of the head and neck. OBJECTIVE To review the results of SLNB for patients with cSCC of the head and neck at the authors’ institution. MATERIALS AND METHODS A retrospective review was completed for patients who underwent SLNB for cSCC of the head and neck over 19 years. Patient demographics, immune status, tumor stage, total patients with positive SLNB, local recurrence, nodal recurrence, in-transit metastasis, and disease-specific death were recorded. RESULTS Sixty patients underwent lymphoscintigraphy, and an SLN was identified in 58 patients. The mean follow-up was 3.2 years (range, 15 days–16 years). Four patients (6.9%) had a positive SLNB. All were Brigham and Women's Hospital (BWH) stage T2b tumors. Three of these patients were immunosuppressed, 3 patients underwent neck dissection, and 2 patients received adjuvant radiation. None developed local or regional recurrence. Of the 53 patients with a negative SLNB, there were 4 local recurrences, 2 in-transit metastases, and no nodal recurrences. CONCLUSION Immunosuppressed patients with tumors BWH stage T2b or greater may be a reasonable cohort to focus future prospective studies on the utility of SLNB in cSCC of the head and neck.

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Cutaneous Squamous Cell Carcinoma Tumour Size is Associated with Sentinel Lymph Node Metastasis in a Cohort of 69 Patients

Cited by 7 publications

References 28 publications

Association of Patient Risk Factors, Tumor Characteristics, and Treatment Modality With Poor Outcomes in Primary Cutaneous Squamous Cell Carcinoma

Association of Patient Risk Factors, Tumor Characteristics, and Treatment Modality With Poor Outcomes in Primary Cutaneous Squamous Cell Carcinoma

Role of Sentinel Lymph Node Biopsy for Skin Cancer Based on Clinical Studies

Outcomes of Sentinel Lymph Node Biopsy for Primary Cutaneous Squamous Cell Carcinoma of the Head and Neck

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