Sentinel Lymph Node Biopsy for High-Risk Nonmelanoma Skin Cancers

Abstract

Compared to melanoma, SCC of the skin are much less predictable as regards their tendency to metastasize to the regional lymph nodes. Although the SLNB appears to be a reliable staging procedure for NMSC (especially SCC), the yield may be too low to justify its routine use in this patient population. More data are needed to determine when a SLNB is justified in the management of NMSC.

Sentinel lymph node biopsy and risk factors for predicting metastasis in cutaneous squamous cell carcinoma

“…In six patients (35%) a negative SLN was thus not associated with a good prognosis, resulting in a low sensitivity for SLNB in cSCCs. In the literature, some studies have shown no false-negative SLNs, 11,20 whereas others had a rate of false-negative SLNBs around 10% 23,24 or 33%. 10 Also, rates for positive SLNs vary from 0% 23 to over 4Á5% 22 up to 44%.…”

“…26 However, other groups have defined a false-negative result as a tumourfree SLNB with metastatic disease at any body site. 23 Using the first, stricter, definition we had one of 17 patients with a false-negative SLN (6%). However, five more patients developed metastatic disease at distant body sites despite a negative SLN.…”

“…SLNB in patients with high-risk cSCC has so far been reported only in case reports or case series. 4,11,[19][20][21][22][23][24] The lack of clearly defined indications for the use of SLNB procedures has led to studies of heterogeneous groups of patients with a varying number of risk factors. 4,[19][20][21][22][23][24] Schmitt et al reanalysed the case series already published in the literature using an alternative staging system and found that most cSCCs associated with positive SLNB findings occurred in T2 lesions > 2 cm in diameter.…”

“…25 All of the published studies used only a short follow-up time. 4,[19][20][21][22][23][24] The aim of this study was to evaluate factors in patients with cSCC that increase the risk of metastasis in a large cohort study with long-term follow-up. And we specifically defined the value of SLNB regarding its sensitivity, negative predictive value and impact on prognosis and outcome.…”

Sentinel Lymph Node Biopsy for Eyelid and Conjunctival Tumors

“…Immunohistochemical stains adipophilin and perilipin for the identification of lipid within specimens have proven to be useful. 57–61 Experience with the use of SLN biopsy in sebaceous carcinoma with ocular 29,33,62 and extraocular 63–65 involvement is limited. To date, SLN positivity rates range from 17% (2/12) 62 to 20% (1/5).…”