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Tumor staging finds most cSCC with positive SLNB occurred in T2 lesions
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Most cutaneous squamous cell carcinomas associated with positive sentinel lymph node biopsies occurred in T2 lesions larger than 2 cm in diameter, according to results using two staging systems.
Jerry D. Brewer, MD, dermatologist at Mayo Clinic, Rochester, Minn., and colleagues conducted a Medline database review of sentinel lymph node biopsies (SLNB) performed for cutaneous squamous cell carcinoma (cSCC), using keywords “squamous or melanoma, cutaneous or skin” and “sentinel or lymphoscintigraphy.” Data also was drawn from private and institutional practices for patients with nonanogenital cSCC who had SLNB performed.
Jerry D. Brewer
The main outcome and measure were positive SLNB results by cSCC stage that were quantified by number and percentage.
Among 19 reports, 130 patients met American Joint Committee on Cancer (AJCC) staging criteria, and 117 others had sufficient data for a recently proposed alternative staging system.
Microscopic nodal metastases were detected by SLNB in 12.3% of patients considered to have high-risk cSCC. All cSCC with positive SLN were greater than 2 cm in diameter.
In both staging systems, most tumors were categorized as T2 lesions. Positive SLNB findings were identified by AJCC criteria in no T1 lesions (n=9; 0%), 13 T2 lesions (n=116; 11.2%) and three T4 lesions (n=5; 60%). Using the alternative staging system, positive results were identified in no T1 lesions (n=9; 0%), six T2a lesions (n=85; 7.1%), five T2b lesions (n=17; 29.4%) and three T3 lesions (n=6; 50%). Rates of positive SLNB findings among patients with T2b lesions were greater than those with T2a lesions (P=.02).
“The data are incomplete about the utility of SLNB in patients with cSCC,” the researchers concluded. “Findings thus far, however, suggest that SLNB accurately identifies SLN and is well tolerated. [SLNB] can provide early detection of subclinical nodal metastases, although the survival benefit is not yet known.”
Disclosure: The researchers report no relevant financial disclosures.
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