Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine & The Winship Cancer Institute, Atlanta, Georgia, USA.
J Surg Oncol. 2010 Sep 15;102(4):315-20. doi: 10.1002/jso.21635.
Biopsy of Cloquet's node (CN) during groin dissection has been used to indicate need for pelvic dissection. With earlier detection of microscopic regional disease in the era of sentinel node biopsy (SNB), frequency of positive CN may be so low that routine biopsy is unwarranted.
Patients with positive groin SNB from 2000 to 2008 were identified from two centers. Cases where CN was identified at completion node dissection were selected. Lymphoscintigraphic, surgical, pathologic, and recurrence data were reviewed.
CN was identified in 53 cases. Median age was 44.5 years (range 7-77); median Breslow depth, 1.98 mm (range 0.5-25.0); % Clark's level IV/V, 90%; and % ulceration, 41.5%. Fifty (94.3%) underwent groin dissection alone; three others underwent concomitant pelvic dissection. Two (3.8%) patients had positive CN; both had additional indications for pelvic dissection. Delayed pelvic recurrence rate was 2/53 (3.8%); both patients had negative CN. In the three patients treated with concurrent groin and pelvic dissection, CN reflected pelvic nodal status in two cases; the third had pelvic metastases despite negative CN.
After positive SNB, disease involvement of CN is rare. Patients with positive biopsies of CN in the SNB era appear likely to have additional indications for pelvic dissection, minimizing utility of CN biopsy. Routine intraoperative sampling of CN may not be warranted during groin dissection for positive SNB.
在腹股沟解剖过程中对 Cloquet 淋巴结（CN）进行活检已被用于指示是否需要进行盆腔解剖。随着前哨淋巴结活检（SNB）时代对微转移区域疾病的更早发现，CN 阳性的频率可能如此之低，以至于常规活检是不必要的。
从两个中心确定了 2000 年至 2008 年间腹股沟 SNB 阳性的患者。选择在完成淋巴结清扫术时发现 CN 的病例。回顾了淋巴闪烁显像、手术、病理和复发数据。
CN 共鉴定出 53 例。中位年龄为 44.5 岁（范围 7-77）；中位 Breslow 深度为 1.98mm（范围 0.5-25.0）；Clark 分级 IV/V 级占 90%；溃疡占 41.5%。50 例（94.3%）仅行腹股沟解剖；另有 3 例患者行同期盆腔解剖。2 例（3.8%）患者的 CN 阳性；两者均有盆腔解剖的其他适应证。53 例患者中有 2 例（3.8%）出现盆腔复发；两者的 CN 均为阴性。在 3 例同时行腹股沟和盆腔解剖的患者中，CN 反映了盆腔淋巴结状态，2 例患者；第三例患者尽管 CN 阴性，但仍有盆腔转移。
在 SNB 阳性后，CN 的疾病受累很少见。在 SNB 时代，CN 活检阳性的患者似乎很可能有盆腔解剖的其他适应证，从而降低了 CN 活检的作用。对于 SNB 阳性的腹股沟清扫术，常规术中取样 CN 可能没有必要。
