Sentinel Lymph Node Biopsy for Cutaneous Squamous Cell Carcinoma on the Head and Neck

Durham, Alison B.; Lowe, Lori; Malloy, Kelly M.; McHugh, Jonathan B.; Bradford, Carol R.; Chubb, Heather; Johnson, Timothy M.; McLean, Scott A.

doi:10.1001/jamaoto.2016.1927

Cited by 54 publications

(56 citation statements)

References 36 publications

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“…A literature review of SLN in SCC found that the majority of false negative biopsies came before the year 2000, in which, a combination of radioisotope and blue dye was not used in SLN identification . Therefore, a combined technique of preoperative lymphoscintigraphy with a tracer and blue dye has been considered to be a reliable and promising technique in SCC . Therefore, the proposed method of SLNB in the setting of SCC should include pre‐operative lymphoscintigraphy performed using technetium sulfur colloid injected intradermally at the site of the primary lesion either on the same day or day before the SLNB.…”

Section: Resultsmentioning

confidence: 99%

“…Intraoperative hand‐held gamma probe then provides guidance to the location of the SLN. A small incision and blunt dissection will allow the surgeon to gain access to the SLN while preserving nearby neurovascular structures …”

Section: Resultsmentioning

confidence: 99%

“…The lymph node is serially sectioned into multiple consecutive sections in order to reveal sequential layers of the tissue structure and stained with H&E to be viewed under the microscope for the presence of cancer spread. If this section is still negative, it is recommended to use immunohistochemical staining to further investigate tumor spread as H&E alone has been shown to commonly miss SCC metastasis . Immunohistochemical stains that may help identify SCC tumor cells within lymph nodes include: AE1, AE3, p63, EMA, HMWK, and CAM‐52 .…”

Section: Resultsmentioning

confidence: 99%

“…Given the under utilization of SLNB in “high‐risk” SCC cases, there is no clear consensus as to the standard of treatment following a positive biopsy. Positive SLNB (including mircometastatic disease) should be followed with a complete lymph node dissection . Radiation therapy is also recommended as an adjuvant to nodal dissection, especially with recurrent tumors or those with perineural invasion .…”

Section: Discussionmentioning

confidence: 99%

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

Ahadiat

Higgins

Sutton

et al. 2017

Journal of Surgical Oncology

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The concept of the sentinel lymph node biopsy (SLNB) has been universally accepted for melanoma, however, remains controversial for squamous cell carcinoma (SCC). We performed a quantitative review on 260 cases of SCC that had a SLNB. The positivity rate was found to be 14.6%. Literature was qualitatively reviewed to determine whether a positive SLNB has any bearing on prognosis in SCC cases, finding a significant relationship between poor prognosis and a positive SLN (P = 0.0082).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Ahadiat

Higgins

Sutton

et al. 2017

Journal of Surgical Oncology

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“…16,26,27 A cirurgia é o tratamento de eleição para o CEC, sendo que as margens de segurança estão definidas pelo Consenso Europeu EDF-EADO-EORTC, baseadas na classificação de Brantsch. 16 Tendo em conta que conhecer a espessura do tumor no pré-operatório pode não ser viável, deve-se ter em conta outros critérios também referidos pelo Consenso Europeu EDF--EADO-EORTC, como por exemplo o diâmetro do tumor, 16 de uso mais prático na clínica.…”

Section: Revista Spdv 75(1); Cancro Cutâneo De Cabeça E Pescoço; Miguunclassified

A Metastização Cervical dos Cancros Cutâneos de Cabeça e Pescoço

Oliveira

Cabete

Semedo

et al. 2017

SPDV

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RESUMO -O cancro cutâneo é a neoplasia mais frequente de todas, com maior incidência na área de cabeça e pescoço, pela fotoexposição crónica. A estratificação do risco metastático linfático regional cervical tende a ser sistematizada de acordo com modelos de estadiamento tumoral, que são tendencialmente aceites no melanoma e carcinoma de células de Merkel, mas pouco consensuais no carcinoma espinocelular. Um dos focos de investigação é o risco de micrometástases em casos de tumores de estádio clínico e imagiológico N0, de que um modo geral varia entre 5% a 20% nos carcinomas espinocelulares, cerca de 20% nos melanomas e de 20 a 50% nos carcinomas de células de Merkel, dependendo de vários fatores de risco. A utilidade do gânglio sentinela e os protocolos de acompanhamento são também matéria de discussão. PALAVRAS-CHAVE - INTRODUÇÃOO cancro cutâneo é a neoplasia mais frequente no ser humano, com uma incidência de cerca de 2 milhões de casos/ano nos Estados Unidos. 1,2 A cabeça e pescoço, por ser uma área exposta a radiação solar, é também a de maior risco e maior frequência dos tumores cutâneos, contando com cerca de 80% dos casos. 2 Em Portugal não é possível uma comparação direta, já que o registo oncológico regional apenas contabiliza o melanoma maligno da pele. 3 A gestão terapêutica dos tumores cutâneos de cabeça e pescoço é delicada, sobretudo na gestão das margens cirúrgicas, pelas implicações na anatomia e função desta área esteticamente sensível. 4 Também a questão da metastização linfática regional é de complexa abordagem diagnóstica e cirúrgica devido a um padrão de drenagem linfática variável, arborização complexa e proximidade de estruturas vitais (como por exemplo via aérea, artéria carótida, veia jugular, canal torácico, nervos pneumogástri-co, frénico, espinhal e nervo facial). 5,6

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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 Cutaneous Squamous Cell Carcinoma on the Head and Neck

Cited by 54 publications

References 36 publications

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

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

A Metastização Cervical dos Cancros Cutâneos de Cabeça e Pescoço

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

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