Sentinel lymph node biopsy with a gamma probe in patients with high-risk cutaneous squamous cell carcinoma

• DOI: 10.1097/mnm.0b013e32834b76cf
• Publication Date: 2011-10-04T18:08:47Z
• Authors: Hakan Demir; Tonguc Isken; Evrim Kus; Yusuf Ziya Tan; Serkan Isgoren; Gozde Daglioz Gorur; Alper Oc; Cenk Sen; Deniz Cek; Cengiz Ercin; Fatma Berk
• Keywords: Aged, 80 and over; Male; Skin Neoplasms; Sentinel Lymph Node Biopsy; Middle Aged; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Lymphatic Metastasis; Carcinoma, Squamous Cell; Humans; Female; Gamma Cameras; Lymph Nodes; Prospective Studies; Technetium Tc 99m Aggregated Albumin; Lymphoscintigraphy; Aged; Follow-Up Studies

Lymphoscintigraphy (LS) and sentinel lymph node biopsy have become the standard of care for melanoma and breast cancer. However, the data on patients with cutaneous squamous cell carcinoma (SCC) are limited. We aimed to evaluate and identify the role of LS and sentinel lymph node biopsy in patients with high-risk cutaneous SCC.Nineteen patients (13 men, six women; 47-87 years of age, mean age 67.5 ± 12.3) with SCC were included in the study. LS was performed on all patients after intracutaneous injection of Tc-99m nanocolloid. Primary lesions and sentinel lymph nodes (SLNs) were excised with the help of a gamma probe.A total of 26 SLNs and 32 secondary lymph nodes were imaged on LS and were marked. During surgery, 29 SLNs, 21 secondary lymph nodes and three nonactive lymph nodes were excised. In total, 53 lymph nodes were removed surgically. A histopathological study revealed that all lymph nodes were negative for metastasis. Patients were followed up for an average of 41.1 ± 22.2 months (7-80 months). Until the time of data collection, 14 patients were alive and had no regional lymph node or distant metastasis. Local recurrence was seen in only one patient. He was reoperated upon 38 months ago.The feasibility of determining SLNs using LS and an intraoperative gamma probe in patients with cutaneous SCC was shown. Unnecessary elective lymph node dissection and possible complications could be avoided in 19 patients.