Sentinel lymph node biopsy with a gamma probe in patients with high-risk cutaneous squamous cell carcinoma: follow-up results of sentinel lymph node-negative patients

Nucl Med Commun. 2011 Dec;32(12):1216-22. doi: 10.1097/MNM.0b013e32834b76cf.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / secondary
  • Female
  • Follow-Up Studies
  • Gamma Cameras
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphoscintigraphy / methods*
  • Lymphoscintigraphy / standards
  • Male
  • Middle Aged
  • Prospective Studies
  • Sentinel Lymph Node Biopsy / methods*
  • Sentinel Lymph Node Biopsy / standards
  • Skin Neoplasms / diagnostic imaging*
  • Skin Neoplasms / pathology
  • Technetium Tc 99m Aggregated Albumin

Substances

  • Technetium Tc 99m Aggregated Albumin
  • technetium Tc 99m nanocolloid