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Journal of Skin Cancer
Volume 2013 (2013), Article ID 267474, 8 pages
http://dx.doi.org/10.1155/2013/267474
Review Article

Sentinel Lymph Node Biopsy in Nonmelanoma Skin Cancer Patients

1Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland
2Department of Nuclear Medicine, University Hospital CHUV, Lausanne, Switzerland
3Department of Pathology, University Hospital CHUV, Lausanne, Switzerland

Received 23 August 2012; Revised 24 December 2012; Accepted 7 January 2013

Academic Editor: Günther Hofbauer

Copyright © 2013 Marie-Laure Matthey-Giè et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.