Importance of sentinel lymphatic node biopsy in patients with low-risk and high-risk cutaneous squamous cell carcinoma

Abstract

Background

Cutaneous squamous cell carcinoma (CSCC) is the second most common non-melanoma skin cancer type. The purpose of our study was to compare the diagnosis of CSCC micrometastases using sentinel lymphatic node biopsy (SLNB) in sentinel lymphatic nodes (SLN) in patients with high-risk and low-risk CSCC.

Methods

A prospective clinical study was carried out. Patients with clinically diagnosed and histologically confirmed CSCC were included in the study if no metastases were observed preoperatively. Patients were divided into low-risk (n = 42) and high-risk (n = 46) groups according to the risk factors. Patients underwent a one-stage operation, tumor excision, and SLNB. Primary tumor characteristics and metastases rates were compared between the groups. Statistical analysis was performed using SPSS 21.0 software. A significance level of 0.05 was chosen.

Results

Micrometastases were found in three high-risk group patients (6.54%). However, the rate of micrometastases in the low-risk group was 0%. The mean size of primary tumors in the low-risk group was 0.97 cm ± 0.44 and was 2.25 cm ± 1.74 in the high-risk group (p < 0.001). The distribution of ulcerated and non-ulcerated tumors differed between the risk groups (p = 0.035). The mean Breslow thickness of CSCC was higher in the high-risk group (2.97 mm ± 1.49 versus 1.39 mm ± 0.51 in the low-risk group, p < 0.001).

Conclusions

According to the results of our study, SLNB should be performed for high-risk CSCC patients only. Primary tumor size, depth, and fact of ulceration correlate with the rate of micrometastases, which is 6.54% for high-risk CSCC patients.

Level of Evidence: Level II, risk/prognostic study.