Sentinel lymph node biopsy for high‐risk cutaneous squamous cell carcinoma of the head and neck

Wu, Michael P; Sethi, Rosh K.V.; Emerick, Kevin S.

doi:10.1002/lary.27881

Cited by 17 publications

(16 citation statements)

References 17 publications

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“…The false-negative rate in our study (n = 4; 5.7%) is consistent with a recent literature review highlighting a rate of 4.6% (10). Only Wu et al (18) reported a falsenegative rate of 0%, after excluding patients with concur-rent local recurrence. In each of our 4 false-negative cases, immunohistochemical staining was carried out.…”

Section: Discussionsupporting

confidence: 91%

“…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%). This is a substantial limit, considering that there were not enough SN + patients in our series to perform a multivariable analysis and identify independent predictive variables.…”

Section: Discussionsupporting

confidence: 82%

“…Another flaw in the SLNB procedure is its failure rate of 6.8% in our series, which is poorly described in oncodermatology literature. In the study by Wu et al (18), the failure rate was 5.7%.…”

Section: Discussionmentioning

confidence: 92%

“…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. This paper discusses the experience of 2 Toulouse-based teams in SLNB for cSCC.…”

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: 91%

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

See 2 more Smart Citations

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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“…More prospective, randomized, large cohort, clinical trials are needed for collecting high‐quality data from which consensus guidelines can be developed for determining which patients might benefit most from a specific type of adjuvant therapy or combination of therapies. Importantly, this includes prospective studies of prognostic testing, such as GEP testing or SLNB, in patients with high‐risk cSCC 2,23–27 . This additional testing would help determine which patients truly need adjuvant therapy and which patients may be managed more appropriately without adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant therapy for high‐risk cutaneous squamous cell carcinoma: 10‐year review

Newman

Hall²,

Kurley³

et al. 2021

Head & Neck

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Standard of care for high‐risk cutaneous squamous cell carcinoma (cSCC) is surgical excision of the primary lesion with clear margins when possible, and additional resection of positive margins when feasible. Even with negative margins, certain high‐risk factors warrant consideration of adjuvant therapy. However, which patients might benefit from adjuvant therapy is unclear, and supporting evidence is conflicting and limited to mostly small retrospective cohorts. Here, we review literature from the last decade regarding adjuvant radiation therapy and systemic therapy in high‐risk cSCC, including recent and current trials and the role of immune checkpoint inhibitors. We demonstrate evidence gaps in adjuvant therapy for high‐risk cSCC and the need for prognostic tools, such as gene expression profiling, to guide patient selection. More large‐cohort clinical studies are needed for collecting high‐quality, evidence‐based data for determining which patients with high‐risk cSCC may benefit from adjuvant therapy and which therapy is most appropriate for patient management.

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Association of Patient Risk Factors, Tumor Characteristics, and Treatment Modality With Poor Outcomes in Primary Cutaneous Squamous Cell Carcinoma

et al. 2023

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ImportancePrimary cutaneous squamous cell carcinoma is usually curable; however, a subset of patients develops poor outcomes, including local recurrence, nodal metastasis, distant metastasis, and disease-specific death.ObjectivesTo evaluate all evidence-based reports of patient risk factors and tumor characteristics associated with poor outcomes in primary cutaneous squamous cell carcinoma and to identify treatment modalities that minimize poor outcomes.Data SourcesPubMed, Embase, and SCOPUS databases were searched for studies of the topic in humans, published in the English language, from database inception through February 8, 2022.Study SelectionTwo authors independently screened the identified articles and included those that were original research with a sample size of 10 patients or more and that assessed risk factors and/or treatment modalities associated with poor outcomes among patients with primary cutaneous squamous cell carcinoma.Data Extraction and SynthesisData extraction was performed by a single author, per international guidelines. The search terms, study objectives, and protocol methods were defined before study initiation. A total of 310 studies were included for full-text assessment. Owing to heterogeneity of the included studies, a random-effects model was used. Data analyses were performed from May 25 to September 15, 2022.Main Outcomes and MeasuresFor studies of risk factors, risk ratios and incidence proportions; and for treatment studies, incidence proportions.ResultsIn all, 129 studies and a total of 137 449 patients with primary cutaneous squamous cell carcinoma and 126 553 tumors were included in the meta-analysis. Several patient risk factors and tumor characteristics were associated with local recurrence, nodal metastasis, distant metastasis, disease-specific death, and all-cause death were identified. Among all factors reported by more than 1 study, the highest risks for local recurrence and disease-specific death were associated with tumor invasion beyond subcutaneous fat (risk ratio, 9.1 [95% CI, 2.8-29.2] and 10.4 [95% CI, 3.0- 36.3], respectively), and the highest risk of any metastasis was associated with perineural invasion (risk ratio, 5.0; 95% CI, 2.3-11.1). Patients who received Mohs micrographic surgery had the lowest incidence of nearly all poor outcomes; however, in some results, the 95% CIs overlapped with those of other treatment modalities.Conclusions and RelevanceThis meta-analysis identified the prognostic value of several risk factors and the effectiveness of the available treatment modalities. These findings carry important implications for the prognostication, workup, treatment, and follow-up of patients with primary cutaneous squamous cell carcinoma.Trial RegistrationPROSPERO Identifier: CRD42022311250

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Sentinel lymph node biopsy for high‐risk cutaneous squamous cell carcinoma of the head and neck

Cited by 17 publications

References 17 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

Adjuvant therapy for high‐risk cutaneous squamous cell carcinoma: 10‐year review

Association of Patient Risk Factors, Tumor Characteristics, and Treatment Modality With Poor Outcomes in Primary Cutaneous Squamous Cell Carcinoma

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