Sentinel Lymph Node Biopsy in Nonmelanoma Skin Cancer Patients
Identifieur interne : 003167 ( Main/Exploration ); précédent : 003166; suivant : 003168Sentinel Lymph Node Biopsy in Nonmelanoma Skin Cancer Patients
Auteurs : Marie-Laure Matthey-Giè [Suisse] ; Ariane Boubaker [Suisse] ; Igor Letovanec [Suisse] ; Nicolas Demartines [Suisse] ; Maurice Matter [Suisse]Source :
- Journal of Skin Cancer [ 2090-2905 ] ; 2013.
Abstract
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 4.5–28% SCC (according to risk factors), in 9–42% MCC, and in 14–57% 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.
Url:
DOI: 10.1155/2013/267474
PubMed: 23476781
PubMed Central: 3586496
Affiliations:
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Ariane" uniqKey="Boubaker A" first="Ariane" last="Boubaker">Ariane Boubaker</name><affiliation wicri:level="3"><nlm:aff id="I2">Department of Nuclear Medicine, University Hospital CHUV, Lausanne, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Nuclear Medicine, University Hospital CHUV, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Letovanec, Igor" sort="Letovanec, Igor" uniqKey="Letovanec I" first="Igor" last="Letovanec">Igor Letovanec</name><affiliation wicri:level="3"><nlm:aff id="I3">Department of Pathology, University Hospital CHUV, Lausanne, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Pathology, University Hospital CHUV, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Demartines, Nicolas" sort="Demartines, Nicolas" uniqKey="Demartines N" first="Nicolas" last="Demartines">Nicolas Demartines</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Visceral Surgery, University Hospital CHUV, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author><author><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" last="Matter">Maurice Matter</name><affiliation wicri:level="3"><nlm:aff id="I1">Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Visceral Surgery, University Hospital CHUV, Lausanne</wicri:regionArea><placeName><settlement type="city">Lausanne</settlement><region nuts="3" type="region">Canton de Vaud</region></placeName></affiliation></author></analytic><series><title level="j">Journal of Skin Cancer</title><idno type="ISSN">2090-2905</idno><idno type="eISSN">2090-2913</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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 4.5–28% SCC (according to risk factors), in 9–42% MCC, and in 14–57% 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.
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sortKey="Fitzgerald, Tl" uniqKey="Fitzgerald T">TL Fitzgerald</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hsu, Hc" uniqKey="Hsu H">HC Hsu</name></author><author><name sortKey="Ho, Cy" uniqKey="Ho C">CY Ho</name></author><author><name sortKey="Chen, Ch" uniqKey="Chen C">CH Chen</name></author><author><name sortKey="Yang, Ch" uniqKey="Yang C">CH Yang</name></author><author><name sortKey="Hong, Hs" uniqKey="Hong H">HS Hong</name></author><author><name sortKey="Chuang, Yh" uniqKey="Chuang Y">YH Chuang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Beyeler, M" uniqKey="Beyeler M">M Beyeler</name></author><author><name sortKey="Kempf, W" uniqKey="Kempf W">W Kempf</name></author><author><name sortKey="Hafner, J" uniqKey="Hafner J">J Hafner</name></author><author><name sortKey="Burg, G" uniqKey="Burg G">G Burg</name></author><author><name sortKey="Dummer, R" uniqKey="Dummer R">R Dummer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tan, Est" uniqKey="Tan E">EST Tan</name></author><author><name sortKey="Tang, Mby" uniqKey="Tang M">MBY Tang</name></author><author><name sortKey="Tan, Sh" uniqKey="Tan S">SH Tan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wang, Ch" uniqKey="Wang C">CH Wang</name></author><author><name sortKey="Nien, Hc" uniqKey="Nien H">HC Nien</name></author><author><name sortKey="Hou, Mf" uniqKey="Hou M">MF Hou</name></author><author><name sortKey="Chen, Gs" uniqKey="Chen G">GS Chen</name></author><author><name sortKey="Cheng, St" uniqKey="Cheng S">ST Cheng</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Suisse</li></country><region><li>Canton de Vaud</li></region><settlement><li>Lausanne</li></settlement></list><tree><country name="Suisse"><region name="Canton de Vaud"><name sortKey="Matthey Gie, Marie Laure" sort="Matthey Gie, Marie Laure" uniqKey="Matthey Gie M" first="Marie-Laure" last="Matthey-Giè">Marie-Laure Matthey-Giè</name></region><name sortKey="Boubaker, Ariane" sort="Boubaker, Ariane" uniqKey="Boubaker A" first="Ariane" last="Boubaker">Ariane Boubaker</name><name sortKey="Demartines, Nicolas" sort="Demartines, Nicolas" uniqKey="Demartines N" first="Nicolas" last="Demartines">Nicolas Demartines</name><name sortKey="Letovanec, Igor" sort="Letovanec, Igor" uniqKey="Letovanec I" first="Igor" last="Letovanec">Igor Letovanec</name><name sortKey="Matter, Maurice" sort="Matter, Maurice" uniqKey="Matter M" first="Maurice" last="Matter">Maurice Matter</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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