SLNB in cutaneous SCC: A review of the current state of literature and the direction for the future

Ahadiat, Omeed; Higgins, Shauna; Sutton, Adam; Ly, Alexandre; Wysong, Ashley

doi:10.1002/jso.24675

Cited by 28 publications

(25 citation statements)

References 58 publications

(117 reference statements)

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“…To our knowledge, this is the second largest ever published series concerning SLNB and non-ano-genital highrisk cSCC. Its positivity rate of 11.6% (n = 8) is consistent with the latest literature reviews, reporting rates ranging from 8% (22) to 14.6% (17). The largest series by Wu et al (18) included 83 patients, but only 5 SLNB were positive (6%).…”

Section: Discussionsupporting

confidence: 81%

“…On the one hand, there is no data to confirm that diagnosis of microscopic lymph node metastasis in cSCC leads to a better prognosis than later diagnosis (22,23). On the other hand, a literature review of 260 procedures taken from 14 studies (17) revealed that patients with confirmed subclinical node metastasis still had a significantly higher mortality rate than SLNB-negative patients (p = 0.008), despite appropriate adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

“…However, SLNB is still not routinely recommended in the work-up of clinically N0 high-risk cSCC because of a lack of high-level evidence, not in terms of efficiency (16,17) but in terms of patient screening. Although more data are being published on this topic, to our knowledge, the largest series reported included 83 patients with highrisk cSCC (18) and the procedure remains controversial.…”

mentioning

confidence: 99%

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

Chabrillac¹,

Lusque²,

Cavallier³

et al. 2019

Acta Derm Venereol

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SIGNIFICANCEAmong patients presenting a cutaneous squamous cell carcinoma, this study analyses the patient's and tumour's characteristics associated with metastasis in the first draining lymph node, called the "sentinel lymph node". The results show that a large tumour size is a risk factor for lymph node metastasis.Ten to fifty percent of high-risk cutaneous squamous cell carcinoma may potentially metastasize. However, the concept of sentinel lymph node biopsy remains controversial for cutaneous squamous cell carcinoma. The aim of this study was to identify prognostic factors associated with sentinel lymph node positivity. A bicentric retrospective analysis was conducted between January 2006 and January 2018. All patients undergoing sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma were included, based on the criteria of the prognostic classification of the French Society of Dermatology. Seventy-four patients were included. Five (6.8%) procedures failed. Of the 69 patients assessed, the positive sentinel lymph node biopsy rate was 11.6% (n = 8) with a false negative rate of 5.7% (n = 4). The positivity of sentinel lymph node biopsy was associated with tumour size (p = 0.0194). Sentinel lymph node biopsy is an effective staging procedure for clinically N0 high-risk cutaneous squamous cell carcinoma, with an acceptable morbidity. To date, 2 risk factors of sentinel lymph node positivity have been identified with statistical significance: tumour size and poor tumour differentiation.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Chabrillac¹,

Lusque²,

Cavallier³

et al. 2019

Acta Derm Venereol

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“…Although most patients diagnosed with CSCC have a good prognosis, a few cases in the high-risk group with the criteria of poor diagnosis have an aggressive clinical course and higher rates of local recurrence and metastasis (5,(9)(10)(11)(12). Risk factors defined by AJCC are shown in Table 2 An important point to be noted in our study was that the presence of PNI (n:2) was detected in all CSCC patients with a diameter > 2 cm.…”

Section: Discussionmentioning

confidence: 53%

“…The lymph node in the body region to which a malignant tumor first drains is named as sentinel lymph node (SLN). This is the first lymphoid target where tumors reach for the first time via lymphatic route (4,(7)(8)(9)(10)(11)(12)(13). The importance of SLN sampling in identification of the occult lymph node metastases has been established, and accepted as a prognostic factor (14).…”

Section: Introductionmentioning

confidence: 99%

High Risk Factors and Sentinel Lymph Node Biopsy in Cutaneous Squamous Cell Carcinoma: Analysis of Prevalence and Recurrence

Oltulu

2018

std

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Amaç: Kutanöz skuamöz hücreli karsinomların (KSHK) erken dönemde teşhis edilmesi prognozu etkileyen en önemli faktördür ve iyi prognoza sahip vakalar çoğunluktadır. Yüksek riskli grup olarak tanımlanan bazı vakaların bölgesel tekrarlama ve uzak metastaz oranları oldukça yüksek olup agresif bir seyir izlerler. Son zamanlarda KSHK'larda Sentinel lenf nodu (SLN) örneklemesinin önemini belirlemeye dönük pek çok çalışma yapılmakta ve SLN pozitifliği ile kötü prognoz ilişkilendirilmektedir. Bu çalışmada, KSHK tanısı alan yüksek risk faktörlü vakalarda SLN sonuçlarının prognostik öneminin belirlenmesi amaçlandı. Hastalar ve Yöntem: 2009-2017 yılları arasında KSHK tanısı ile eksizyonel operasyon yapılmış, klinik ve patolojik verileri eksiksiz, çeşitli vücut bölgelerinden toplam 29 hasta çalışmaya dahil edildi. Hastaların yüksek risk faktörleri ve sentinel lenf nodu biopsi sonuçları ile en az 9 aylık klinik takip sonuçları kaydedilerek analiz edildi. AJCC Yüksek risk faktörlerinden en az birine sahip hastalar yüksek riskli grup olarak kabul edildi. Bulgular: Toplam 29 KSHK hastasının 25 tanesi yüksek risk grubunda idi. Yüksek riskli KSHK hastalarında SLN pozitiflik oranı %12 (n:3/25) olup, düşük riskli 4 hastanın tamamında SLN'ları negatifti. SLN pozitif hastaların tamamına lokal tamamlayıcı lenfadenektomi uygulandı ve hepsi nüks sebebiyle tekrar opere edildi. Yüksek riskli-SLN pozitif KSHK hastalarında nüks oranı %100 (n:3/3); Yüksek riskli-SLN negatif KSHK hastalarında nüks oranı %18 (n:4/22) idi. El-ayak lokalizasyonlu hastalarda yüksek nüks oranları (%41.6) ve SLN pozitifliği belirlendi. Sonuç: SLN pozitif hastalarda ilerleyen hastalık sürecinde çok büyük oranlarda lokal nüks görülebilmektedir. KSHK'larda el-ayak bölgesi lokalizasyonu; tümörün çapının 0.6 cm'in üzerinde olması gerekliliğine bakılmaksızın direkt olarak bir yüksek risk faktörü olabilir. Anahtar Kelimeler: kutanöz, skuamöz hücreli karsinom, sentinel lenf nodu, yüksek risk, rekürrens Aim: Early diagnosis of cutaneous squamous cell carcinomas (CSCC) is the most important factor affecting prognosis and most patients have a good prognosis. Some patients defined as high-risk group have high rates of regional recurrence and distant metastasis, and follow an aggressive course. In addition, recently numerous studies have being performed for determining the importance of sentinel lymph node sampling, and sentinel lymph node (SLN) positivity has been associated with a poor prognosis. In this study, we aimed to determine prognostic importance of SLN outcomes in patients with high-risk patients diagnosed with CSCC. Patients & Methods: A total of 29 patients who underwent excisional operation in various body regions with the diagnosis of CSCC between 2009 and 2017, with available complete clinical and pathologic data were included in the study. At least 9-month clinical follow-up results, high risk factors and sentinel lymph node biopsy outcomes of the patients were recorded and analyzed. Patients with at least one of the American Joint Committee on Cancer (AJCC) cri...

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Prognostic Value of Tumor Staging: Predicting Nodal Metastases in Cutaneous Squamous Cell Carcinoma

et al. 2020

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Objectives Determine the ability of three staging systems to stratify the risk of nodal metastases in cases of cutaneous squamous cell carcinoma (cSCC). Examine differential staging of tumors across the three systems and the resulting implications for clinical decision making. Study Design Retrospective chart review. Methods This study included 118 patients who underwent excision of primary cSCC of the head and neck as well as elective neck dissection for the same tumor between 2006 and 2017. Tumors were staged using the 2010 7th edition American Joint Committee on Cancer (AJCC 7) staging system, the 2016 8th edition AJCC staging system (AJCC 8), and the Brigham and Women's Hospital (BWH) alternative tumor staging system published in 2013. Results There were 28 patients (23.7%) with positive nodal metastases at the time of tumor excision. Almost all tumors staged as tumor (T)2 using AJCC 7 were upstaged to T3 or T4 using the new AJCC 8, and these two groups accounted for the majority of the nodal metastases. Similarly, the BWH‐staged T3 group contained the highest number of tumors with nodal metastases. None of the three staging systems significantly stratified tumors in a manner that predicted the presence of nodal metastases. Conclusion Individuals with cSCC tumors staged T3 or higher in the AJCC 8 and BWH staging systems should undergo neck dissection, whereas those with lower staging should be discussed with the patient on a case‐by‐case basis. Level of Evidence: 4

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SLNB in cutaneous SCC: A review of the current state of literature and the direction for the future

Cited by 28 publications

References 58 publications

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

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

High Risk Factors and Sentinel Lymph Node Biopsy in Cutaneous Squamous Cell Carcinoma: Analysis of Prevalence and Recurrence

Prognostic Value of Tumor Staging: Predicting Nodal Metastases in Cutaneous Squamous Cell Carcinoma

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