Limited Value of Staging Squamous Cell Carcinoma of the Anal Margin and Canal Using the Sentinel Lymph Node Procedure: A Prospective Study with Long-Term Follow-UpReport as inadecuate




Limited Value of Staging Squamous Cell Carcinoma of the Anal Margin and Canal Using the Sentinel Lymph Node Procedure: A Prospective Study with Long-Term Follow-Up - Download this document for free, or read online. Document in PDF available to download.

Annals of Surgical Oncology

, Volume 17, Issue 10, pp 2656–2662

First Online: 14 April 2010Received: 08 July 2009

Abstract

BackgroundSelection of patients with anal cancer for groin irradiation is based on tumor size, palpation, ultrasound, and fine needle cytology. Current staging of anal cancer may result in undertreatment in small tumors and overtreatment of large tumors. This study reports the feasibility of the sentinel lymph node biopsy SLNB in patients with anal cancer and whether this improves the selection for inguinal radiotherapy.

MethodsA total of 50 patients with squamous anal cancer were evaluated prospectively. Patients without a SLNB n = 29 received irradiation of the inguinal lymph nodes based on lymph node status, tumor size, and location of the primary tumor. Inguinal irradiation treatment in patients with a SLNB was based on the presence of metastases in the SLN.

ResultsSLNs were found in all 21 patients who underwent a SLNB. There were 5 patients 24% who had complications after SLNB and 7 patients 33% who had a positive SLN and received inguinal irradiation. However, 2 patients with a tumor-free SLN and no inguinal irradiation developed lymph node metastases after 12 and 24 months, respectively.

ConclusionsWe conclude that SLNB in anal cancer is technically feasible. SLNB can identify those patients who would benefit from refrain of inguinal irradiation treatment and thereby reducing the incidence of unnecessary inguinal radiotherapy. However, because of the occurrence of inguinal lymph node metastases after a tumor-negative SLNB, introduction of this procedure as standard of care in all patients with anal carcinoma should be done with caution to avoid undertreatment of patient who otherwise would benefit from inguinal radiotherapy.

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Author: Johannes S. de Jong - Jannet C. Beukema - Gooitzen M. van Dam - Riemer Slart - Clara Lemstra - Theo Wiggers

Source: https://link.springer.com/article/10.1245/s10434-010-1063-7



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