Abstract
Squamous cell carcinomas are among the most common skin tumors and show a risk of metastasis depending on various factors such as tumor thickness, localization, histological subtype and immune status of the patient. Sentinel lymph node biopsy (SLNB) SLNB represents a possibility for assessing the locoregional lymph node status. In this study, the role of the SLNB in lymph node status and survival was analyzed. Retrospectively, 720 patients with high-risk squamous cell carcinoma (tumor thickness > 5 mm) were examined. 150 patients agreed to SLNB, 570 patients did not undergo histologic confirmation of lymph node status and were included directly in follow-up. In 101 patients, a sentinel lymph node was successfully marked and extirpated, followed by regular follow-up examinations.A total of 11.11% of the patients showed lymph node metastasis in the course of their treatment, with no difference in the proportion of patients in the SLNB group (11.9%) and the observation group (11.4%) (p = 0.873). The proportion of distant metastasis also did not differ between the groups (p = 0.898). In 3.96% of the patients in the SLNB group, a metastasis was found in the sentinel lymph node. Tumor-specific death was observed in 7.14% of the patients in the SLNB group and 4.74% in the observation group (p = 0.269). Although SLNB is a principally suitable method for determining lymph node status, the available data do not provide any benefit regarding further metastasis or tumor-specific survival.
Highlights
Cutaneous squamous cell carcinomas are the second most frequent skin tumors [23]
Incomplete data sets were found in 24 patients of the Sentinel lymph node biopsy (SLNB) group, which led to their exclusion from further analysis
The median follow-up was 2.92 years in the SLNB group and 2.82 years in the observation group. Patients of both groups did not differ with regard to the average tumor diameter, safety distance of primary excision, tumor differentiation of the primary tumor or the proportion of desmoplastic squamous cell carcinoma
Summary
Cutaneous squamous cell carcinomas (cSCC) are the second most frequent skin tumors [23]. A recent epidemiological study expects the incidence of non-melanoma skin cancer to double by the year 2030 [19]. This is of considerable importance, as cSCC has metastatic potential and shows aggressive courses in immunosuppressed patients [26, 29]. Various factors contribute to the risk of progressive disease in cSCC, including tumor parameters such as tumor thickness, histological subtype and tumor localization, as well as patientrelated factors such as the presence of immunosuppression [5, 32, 33]. Tumor thickness plays an important role for the risk of local recurrence after excision as well as for metastasis [33]. Brantsch et al were able to show that metastasis only occurred in patients with a tumor thickness of at least 2 mm [5]
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