Sentinel lymph node biopsy for cutaneous head and neck malignancies

Abstract

Sentinel lymph node biopsy (SLNB) is a procedure that can provide critical information regarding pathologic lymph node status and accurate regional staging. This is very important for developing treatment plans and providing prognostic guidance for cutaneous malignancies. The head and neck (HN) region is unique from other body sites due to its complex lymphatic drainage pathways, multiple lymph node basins, proximity of important cranial nerves and potential for contralateral or bilateral drainage. These unique aspects of the HN previously created some uncertainty about the use of SLNB in the HN. This review will discuss the current reliable status of HN SLNB and provide a guide for its current application in cutaneous malignancy of the HN.

Increase of Sentinel Lymph Node Melanoma Staging in The Netherlands; Still Room and need for Further Improvement

“…Noncompliance with SLNB recommendations was also found in the U.S. general population for head-and-neck primary lesions (OR: 2.0; 95% CI, 1.9-2.2) [20,24]. SLNB procedures in the head-and-neck area are technically difficult, even for experienced surgeons, because of the small incisions, critical anatomical structures and great variation in atypical and/or multiple drainage sites [33][34][35][36]. SLNBs and re-excision procedures of limb and trunk melanoma can be safely performed under local anesthesia [37].…”

Systematic review of sentinel lymph node biopsy in Merkel cell carcinoma of the head and neck

“…Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous small cell neuroendocrine tumor. With a predisposition for older to elderly (65‐75 years) white males, it often presents as a rapidly enlarging reddish blue papule, arising on the sun‐exposed head and neck in 40%‐50% . Additional risk factors include chronic ultraviolet light exposure and immunosuppression secondary to lymphoma/leukemia and solid organ transplantation .…”

Parotid Sentinel Lymph Node Biopsy Combined With Intraoperative Facial Nerve Monitoring In Head and Neck Tumor

“…It provides information specific to the individual patient and so is important to provide appropriate personalized and optimal treatment regimes to eliminate the cancer [6,[8][9][10][11][12]. Morton [10] confirmed with the long-term results of the Multicenter Selective Lymphadenectomy Trial that SNB in head and neck melanoma increases both the disease-free and the specific survival of the patient.…”

“…The drawback is that the lymphatic drainage in the head and neck from any one anatomical area is not predictable [6]. This give SLNB it advantage [7].…”