Sentinel Lymph Node Procedure in Patients With Epidermoid Carcinoma of the Anal Canal

Damin, Daniel C.; Rosito, Mário Antonello; Gus, Pedro; Spiro, Bernardo Leão; Amaral, Beatriz; Meurer, Luíse; Cartel, Andre; Schwartsmann, Gilberto

doi:10.1007/s10350-004-7277-7

Cited by 34 publications

(17 citation statements)

References 31 publications

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“…Recent interests in sentinel lymph-node biopsy (SLNB) tries to identify occult metastasis in clinically normal nodes. [40][41][42][43][44] The technique involves preoperative lymphoscintigraphy using radiolabeled agents injected around the tumor and intraoperative detection using a gamma probe. Patent blue dye is usually injected at the margins of the tumor to provide visual identification of the sentinel node.…”

Section: Stagingmentioning

confidence: 99%

Management of Anal Canal Cancer

Sato

Koh

Bartolo

2005

Diseases of the Colon &Amp; Rectum

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To improve treatment outcomes and reduce treatment-related toxicities, further studies are required to elucidate the optimal drug combination and doses, optimal radiation field, total dose, and fraction sizes. Randomized, multicenter trials are needed to define the treatment protocol that provides the highest rate of sphincter preservation with acceptable toxicity. Few studies addressed the treatment of metastatic disease, which remains a major cause of mortality.

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Section: Stagingmentioning

confidence: 99%

Management of Anal Canal Cancer

Sato

Koh

Bartolo

2005

Diseases of the Colon &Amp; Rectum

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“…As recently demonstrated by Mistrangelo and Morino [13], the method has been increasingly used to stage patients with anal cancer. After analyzing the results from the studies investigating SLN in that malignancy [8,[14][15][16][17][18][19][20], they recommend that SLN biopsy should be considered the procedure of choice for staging the inguinal basins in patients with anal cancer. In addition, they suggested that patients with negative SLN should be spared prophylactic inguinal radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, we used the same SLN procedure we had previously investigated in patients with epidermoid carcinoma of the anal canal [8,18]. The SLN biopsy was conducted immediately before performing APR in order to avoid submitting patients to more than one anesthetic procedure.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study undertaken at Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, we prospectively assessed the feasibility of the SLN procedure in patients with epidermoid carcinoma of the anal canal. The proposed technique proved to be safe and highly effective in sampling inguinal sentinel nodes in that type of cancer, allowing the detection of occult micrometastatic deposits in clinically normal nodes [8].…”

Section: Introductionmentioning

confidence: 99%

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Sentinel lymph node in patients with rectal cancer invading the anal canal

et al. 2010

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“…Long-term survival was not documented in any of them. In our patient, we used the same SLN procedure we had previously investigated in cases of epidermoid carcinoma of the anal canal and rectal adenocarcinomas invading the dentate line [5,6]. Our technique, which consisted of a combination of blue dye and radio-colloid, was effective in sampling a SLN from the left inguinal area.…”

mentioning

confidence: 99%

Long-term survival data on sentinel lymph node biopsy in anorectal melanoma

2010

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Sentinel lymph node (SLN) biopsy is currently the method of choice to assess the nodal status of patients with cutaneous melanoma. It has largely replaced elective lymph node dissection, sparing patients with negative SLN the morbidity associated with a complete regional lymphadenectomy. However, experience with the SLN procedure in anal melanoma has been limited to a few reported cases, probably due to the rarity of this tumor. Anorectal melanoma (AM) accounts for 1% of all anorectal malignancies. Most patients are diagnosed with advanced disease and have poor 5-year survival (0-22%). Although surgery is the mainstay of treatment, there appears to be no difference in survival whether wide local excision (LE) or abdominoperineal resection is performed. Locoregional metastases are frequent and may involve both inguinal and pelvic lymph nodes [1].In this letter, we report a case of AM that had an unexpectedly favorable clinical evolution. Our patient was an 89-year-old diabetic woman presenting with an anal lesion that she first noticed 8 months earlier. It was a non-pigmented nodule, 3 cm in diameter, located at the dentate line. Inguinal palpation was unremarkable. Biopsy of the lesion showed an undifferentiated tumor, but the immunohistochemical analysis was positive for S-100 protein and HMB-45, thus establishing the diagnosis of AM. Staging workup did not detect metastases. Considering the general condition of the patient, treatment by wide local excision of the tumor along with SLN biopsy was proposed. Twelve hours before surgery, Dextran 500 labeled with Technetium-99 m was injected into the parenchyma around the primary tumor. Subsequently, lymphoscintigraphy demonstrated a SLN (hot spot) in the right groin (Fig. 1). On the following day, patent blue dye was injected at the same sites around the tumor. The inguinal area was scanned with a gamma probe, and a 3-cm incision was made over the hot spot. During inguinal dissection, the blue color of the SLN served as a guide to its location. After removal of the SLN, excision of the AM was performed. Histopathology and immunohistochemistry of the surgical specimen confirmed AM with tumor-free resection margins. The SLN was diagnosed as positive for metastatic melanoma. The patient refused any additional treatment but remained free of disease after 52 months of follow-up.Although the SLN procedure has been successfully tested in other anal tumors, the investigation into the SLN in AM is currently limited to 6 cases [1-4]. Long-term survival was not documented in any of them. In our patient, we used the same SLN procedure we had previously investigated in cases of epidermoid carcinoma of the anal canal and rectal adenocarcinomas invading the dentate line [5,6]. Our technique, which consisted of a combination of blue dye and radio-colloid, was effective in sampling a SLN from the left inguinal area. Moreover, it allowed the detection of metastatic deposits within the SLN, which

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Sentinel Lymph Node Procedure in Patients With Epidermoid Carcinoma of the Anal Canal

Cited by 34 publications

References 31 publications

Management of Anal Canal Cancer

Management of Anal Canal Cancer

Sentinel lymph node in patients with rectal cancer invading the anal canal

Long-term survival data on sentinel lymph node biopsy in anorectal melanoma

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