Maruyama Hiroshi, Tanaka Ryota, Fujisawa Yasuhiro, Nakamura Yasuhiro, Ito Shusaku, Fujimoto Manabu
Division of Clinical Medicine, Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan.
J Dermatol. 2017 Apr;44(4):431-437. doi: 10.1111/1346-8138.13577. Epub 2016 Sep 26.
Cutaneous squamous cell carcinoma is the second common cutaneous cancer, especially in the elderly. Sentinel lymph node biopsy is generally performed in breast cancers and cutaneous melanomas to detect occult nodal metastases. The benefit of sentinel lymph node biopsy in improving cutaneous squamous cell carcinoma prognosis is doubtful. One hundred and sixty-nine patients who underwent treatment for cutaneous squamous cell carcinoma between 2004 and 2015, and who were followed up for at least 6 months or developed metastases within the follow-up period were included. Forty-nine patients underwent sentinel lymph node biopsy, whereas 120 patients did not, including 13 who exhibited clinical lymph node metastases before treatment. Of these 49 patients, nine (18.4%) presented with sentinel lymph node metastasis, which occurred after treatment in three (6.1%) of them (false-negative). Among the 107 patients who did not undergo lymph node biopsy, 12 (11.2%) developed post-treatment metastases. The metastasis-free and disease-specific survival rates were not significantly different in those who did or did not undergo sentinel lymph node biopsy. Patients with clinical lymph node metastases had a higher risk compared with those without. Patients with T2-T4 tumors had a higher risk compared with those with T1 tumors. When selecting for those with T2 tumors or greater, the same lack of relationship was observed. In conclusion, in this small retrospective cohort, in patients with cutaneous squamous cell carcinoma, there were no significant differences in metastasis-free and disease-specific survival rates between those who did or did not undergo sentinel lymph node biopsy, regardless of T staging.
皮肤鳞状细胞癌是第二常见的皮肤癌,在老年人中尤为常见。前哨淋巴结活检通常用于乳腺癌和皮肤黑色素瘤,以检测隐匿性淋巴结转移。前哨淋巴结活检对改善皮肤鳞状细胞癌预后的益处尚不确定。纳入了2004年至2015年间接受皮肤鳞状细胞癌治疗且随访至少6个月或在随访期间发生转移的169例患者。49例患者接受了前哨淋巴结活检,而120例患者未接受,其中13例在治疗前出现临床淋巴结转移。在这49例患者中,9例(18.4%)出现前哨淋巴结转移,其中3例(6.1%)在治疗后出现转移(假阴性)。在未进行淋巴结活检的107例患者中,12例(11.2%)出现治疗后转移。接受或未接受前哨淋巴结活检的患者的无转移生存率和疾病特异性生存率无显著差异。有临床淋巴结转移的患者比无转移的患者风险更高。T2 - T4期肿瘤患者比T1期肿瘤患者风险更高。在选择T2期或更晚期肿瘤患者时,也观察到同样缺乏相关性。总之,在这个小型回顾性队列中,对于皮肤鳞状细胞癌患者,无论T分期如何,接受或未接受前哨淋巴结活检的患者在无转移生存率和疾病特异性生存率方面均无显著差异。