Utility of Sentinel Lymphadenectomy in the Management of Patients With High-Risk Cutaneous Squamous Cell Carcinoma

Abstract

In this small series of predominantly trunk and extremity high-risk SCCs, sentinel lymph node biopsy was technically feasible with low morbidity. Sentinel lymphadenectomy may prove to have an important role in the management of high-risk cutaneous SCC with a clinical N0 status.

Sentinel node biopsy for squamous cell carcinoma of the head and neck

“…Superficial dermis and epidermis is devoid of lymphatic drainage, making squamous cell carcinoma less likely to spread via lymphatics. Sentinel node biopsy of high risk cutaneous squamous cell carcinomas is currently under investigation by several groups, however the number of cases reported to date is not adequate to draw a conclusion [30][31][32]. We have also attempted to do sentinel node biopsies for a subgroup of cutaneous squamous cell carcinomas perceived to be at high risk based on traditional criteria [33].…”

Special Concern About Squamous Cell Carcinoma of the Scalp in Organ Transplant Recipients

“…With only 1 node in the right side of the neck, XRT was pursued in the appropriate field. 13 Sentinel lymph node biopsy is a relatively low-risk procedure. Optimal management of high-risk SCC may be a combination of local tumor clearance (via Mohs surgery or wide local excision) and sentinel lymph node biopsy in the case of clinically negative results of nodal examination.…”

Sentinel Node Biopsy for High-Risk Nonmelanoma Cutaneous Malignancy

“…27,28 The frequency of regional nodal metastases varies with anatomic site, histologic features such as increasing tumor thickness and histologic dedifferentiation, tumor size, host immune competency, perineural invasion, and prior treatment. 19,[28][29][30][31][32][33][34][35] Squamous cell tumors arising in nonglabrous mucocutaneous sites such as the lip, vulva, penis, and perianal area are also more likely to metastasize than those involving other areas of the skin. 29 Squamous cell carcinoma arising in areas of chronic inflammation, nonhealing wounds, chronic osteomyelitis, and in irradiated fields are known to be particularly aggressive, with rates of nodal metastases between 18% and 30%.…”