Sentinel node biopsy in local anaesthesia in patients with head and neck Merkel cell carcinoma

Abstract

The purpose of this study was to evaluate the applicability of sentinel lymph node (SLN) biopsy in patients with head and neck Merkel cell carcinoma (MCC). A prospective study for nine stage I MCC head and neck patients was conducted between 2001 and 2005. Patients underwent SLN biopsy in conjunction with radical tumour excision. Nine consecutive head and neck MCC patients were included, of whom five were women. All the patients were at stage I. In one patient, no SLNs could be localised on lymphoscintigraphy or perioperatively; eight patients underwent removal of one eight SLNs. None of the patients had any complications directly related to the SLNB. Those patients who demonstrated metastatic disease in the SLNs had waiting periods of 25 and 54 days, respectively. Only the free microvascular free flap reconstructions were done under general anaesthesia, the other reconstructions and the removal of the SLNs were done under local anaesthesia. Aggressive nature and the head and neck location of most MCCs is challenging for the surgeon. Patients are usually elderly with comorbities, which sets limits for anaesthesia. In our opinion, it is not mandatory to perform SLN biopsy under general anaesthesia.