M. A. Bartz-Kurycki1,2, R. S. Krouse1,2 1Southern Arizona VA Health Care System,Tucson, ARIZONA, USA 2University Of Arizona,Surgery,Tucson, AZ, USA
Introduction: Cutaneous squamous cell cancers (cSCC) are typically non-aggressive, although certain features may indicate possible nodal metastasis. As sentinel node (SLN) mapping may be of utility for high risk cSCC, it is important to evaluate patients who have undergone this procedure.
Methods: A prospective database has been developed by a single surgeon who cares for the majority of aggressive cSCC at the Southern Arizona Veterans Affairs Healthcare System. Patients with multiple poor prognostic indicators (age >75, immunocompromised, differentiation, site of tumor, size of tumor, histologic subtype) were offered SLN. The reason for not offering SLN was poor clinical status. Patient characteristics and screening tests were evaluated.
Results: 68 patients with cSCC underwent SLN over 9 years. All patients were male. 5.98% (4/68) patients had positive metastatic cSCC; 3 patients had false negatives seen with nodal recurrences. Screening tests showed a sensitivity of 57.1% and accuracy of 94.1%. Patients with positive SLN (at time of operation or recurrence) were more likely to have moderately to poorly differentiated tumors, be immunocompromised, or age > 75. All patients with positive nodes had at least 3 poor prognostic indicators.
Conclusion: SLN mapping likely has utility for cSCC patients with multiple poor prognostic indicators. As most patients have head and neck tumors, there are more likely to be false negatives and close follow-up is indicated.