%0 Journal Article
%T Sentinel Lymph Node Biopsy in Nonmelanoma Skin Cancer Patients
%A Marie-Laure Matthey-Gi豕
%A Ariane Boubaker
%A Igor Letovanec
%A Nicolas Demartines
%A Maurice Matter
%J Journal of Skin Cancer
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/267474
%X The management of lymph nodes in nonmelanoma skin cancer patients is currently still debated. Merkel cell carcinoma (MCC), squamous cell carcinoma (SCC), pigmented epithelioid melanocytoma (PEM), and other rare skin neoplasms have a well-known risk to spread to regional lymph nodes. The use of sentinel lymph node biopsy (SLNB) could be a promising procedure to assess this risk in clinically N0 patients. Metastatic SNs have been observed in 4.5每28% SCC (according to risk factors), in 9每42% MCC, and in 14每57% PEM. We observed overall 30.8% positive SNs in 13 consecutive patients operated for high-risk nonmelanoma skin cancer between 2002 and 2011 in our institution. These high rates support recommendation to implement SLNB for nonmelanoma skin cancer especially for SCC patients. Completion lymph node dissection following positive SNs is also a matter of discussion especially in PEM. It must be remembered that a definitive survival benefit of SLNB in melanoma patients has not been proven yet. However, because of its low morbidity when compared to empiric elective lymph node dissection or radiation therapy of lymphatic basins, SLNB has allowed sparing a lot of morbidity and could therefore be used in nonmelanoma skin cancer patients, even though a significant impact on survival has not been demonstrated. 1. Introduction 20 years ago [1], sentinel lymph node biopsy (SLNB) was introduced for melanoma patients and later for numerous other tumors with lymphatic metastatic propensity. Even though surgical oncology community is divided in believers and nonbelievers regarding its application, data show that SLNB has already changed the treatments modalities in melanoma and breast cancer patients, at least with respect to TNM classification. It has allowed a better understanding of disease progression and response to treatment in patients with comparable staging groups. Nonmelanoma skin cancer with potential metastatic spreading to regional lymph nodes regroups skin lesions like high-risk squamous cell carcinoma (SCC), Merkel cell carcinoma (MCC), and pigmented epithelioid melanocytoma (PEM). Because of the low incidence of nonmelanoma skin cancer with potential metastatic spread and the lack of large clinical trials, the use of SLNB in these cases is not well established, and no guidelines are currently available. Previous studies conducted about this subject reported a high rate of positive sentinel nodes (SNs) in nonmelanoma skin cancer: 4.5每28% for SCC [2每4], 16每42% for MCC [5每7], and 14每46% for PEM [8, 9]. In this context, the role of SLNB in nonmelanoma skin
%U http://www.hindawi.com/journals/jsc/2013/267474/