Scalene lymph node dissection

The left scalene fat pad was excised and examined microscopically in 84 consecutive patients with clinically operable carcinoma of the cervix. Eleven, or 13%, of the specimens contained metastatic tumor. The metastases were associated with patients who had tumors in relatively more advanced stages of local growth and usually with parametrial spread, yet exhibited no clinical evidence of local or regional metastasis. Seven of 36 patients with Stages IIB, III, and IV carcinomas of the cervix, and 4 of 22 patients with radiation‐recurrent tumors had scalence lymph node metastases as their only evidence of incurability. No metastases were identified in 26 patients with Stage I and IIA cancer. The complications of biopsy were few and minor. The 13% incidence of metastases to clinically benign scalene lymph nodes of patients with advanced but clinically operable carcinoma of the cervix demonstrated in this preliminary study is considered sufficient to justify routine biopsy of these lymph nodes in patients who, on the basis of clinical examination, may require radical surgery for removal of the tumor.

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Diagnostic scalene node biopsy in the preoperative evaluation of the surgical cancer patient.Five-year experience with 108 cases and literature review

Ketcham

Sindelar

Felix

et al. 1976

Cancer

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Records were reviewed of 108 consecutive patients with a variety of surgically approachable malignancies undergoing scalene node biopsy as part of a preoperative staging evaluation. Metastases to the scalene nodes were detected in 12 patients (11.1%). In six patients the scalene nodes were clinically suspicious before biopsy, but in six with nonpalpable nodes the scalene metastases were occult clinically. Four of the patients with clinically benign, but pathologically positive, scalene biopsies were found among the group of 62 patients with epidermoid carcinoma of the cervix. It was concluded that routine scalene biopsies are justified in the properative evaluation of cancer patients only if the nodes are clinically suspicious, except for in patients with advanced pelvic cancers, in whom the incidence of completely occult scalene metastases is 6% or more.

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Scalene lymph node dissection

Cited by 8 publications

References 7 publications

The Diagnostic Yield of Lymph Node Biopsy

The Diagnostic Yield of Lymph Node Biopsy

Occult metastases to the scalene lymph nodes in patients with clinically operable carcinoma of the cervix

Diagnostic scalene node biopsy in the preoperative evaluation of the surgical cancer patient.Five-year experience with 108 cases and literature review

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