Our Summary

The research paper discusses cutaneous squamous cell carcinoma (cSCC), the second most common skin cancer which usually has a favorable outcome. However, a small number of patients get diagnosed with a high-risk version of this cancer (HRcSCC), which can lead to recurring cancer, the spread of the disease to lymph nodes, and even death. The paper reviews the use of a procedure called sentinel lymph node biopsy (SLNB) for these high-risk patients. This procedure helps doctors find out if the cancer has spread to the lymph nodes. If doctors consider a risk of more than 10% that the cancer has spread to the lymph nodes, then this procedure may benefit certain HRcSCC patients. The paper suggests that SLNB could help in predicting the patient’s outcome and guiding treatment. However, larger studies are needed to identify which patients may benefit from this procedure and whether early detection of cancer spread to the lymph nodes leads to better outcomes.

FAQs

  1. What is a sentinel lymph node biopsy (SLNB) and how does it benefit high-risk cSCC patients?
  2. What percentage of risk for cancer spread to the lymph nodes is considered significant enough to recommend the SLNB procedure?
  3. Are there still uncertainties about the use of SLNB in treating HRcSCC and what further research is needed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sentinel lymph node biopsy is to ensure they understand the purpose of the procedure and its potential benefits in determining the spread of cancer. They should also be informed about the risks and potential complications associated with the procedure. It is important for patients to discuss any concerns or questions they may have with their healthcare provider before undergoing the biopsy.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy include those diagnosed with high-risk cutaneous squamous cell carcinoma (HRcSCC) who have a risk of more than 10% that the cancer has spread to the lymph nodes. These patients may benefit from SLNB in order to determine if the cancer has indeed spread, which can help in predicting the patient’s outcome and guiding treatment decisions. Further research is needed to identify which patients would benefit the most from this procedure and to assess whether early detection of cancer spread to the lymph nodes leads to better outcomes.

Timeline

Before Sentinel Lymph Node Biopsy:

  1. Patient is diagnosed with high-risk cutaneous squamous cell carcinoma (HRcSCC).
  2. Doctors assess the risk of the cancer spreading to the lymph nodes.
  3. If the risk is deemed to be over 10%, doctors may recommend a sentinel lymph node biopsy.
  4. Patient undergoes pre-operative tests and evaluations to prepare for the procedure.

After Sentinel Lymph Node Biopsy:

  1. During the procedure, a radioactive tracer or dye is injected near the tumor to identify the sentinel lymph node.
  2. The sentinel lymph node is removed and examined for cancer cells.
  3. Results from the biopsy help determine if the cancer has spread to the lymph nodes.
  4. Depending on the findings, doctors may recommend further treatment such as lymph node dissection or adjuvant therapy.
  5. Patient undergoes follow-up appointments and monitoring to track the progression of the disease and response to treatment.

What to Ask Your Doctor

  1. What is the purpose of a sentinel lymph node biopsy for my high-risk cutaneous squamous cell carcinoma?
  2. How is a sentinel lymph node biopsy performed and what should I expect during the procedure?
  3. What are the potential risks and complications associated with a sentinel lymph node biopsy?
  4. What are the criteria for determining if I am a candidate for a sentinel lymph node biopsy?
  5. How will the results of the sentinel lymph node biopsy impact my treatment plan and prognosis?
  6. Are there alternative methods for determining if the cancer has spread to the lymph nodes?
  7. How soon after the biopsy will I receive the results and what is the next steps after that?
  8. Will I need any additional treatments or monitoring based on the results of the sentinel lymph node biopsy?
  9. Are there any long-term implications or considerations I should be aware of regarding the sentinel lymph node biopsy?
  10. Are there any ongoing clinical trials or research studies related to sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma that I should be aware of?

Reference

Authors: Navarrete-Dechent C, Veness MJ, Droppelmann N, Uribe P. Journal: G Ital Dermatol Venereol. 2018 Jun;153(3):403-418. doi: 10.23736/S0392-0488.18.05936-9. Epub 2018 Feb 26. PMID: 29485258