The role of sentinel lymph node dissection in the treatment of the skin cancers

SUMMARYThe Role of Sentinel Lymph Node Dissection in the Treatment of the Skin CancersA sentinel lymph node is defined as the first node in a nodal basin that receivesthe afferent lymphatic drainage from a given anatomic area. Development of theconcept of sentinel lymph node and the sentinel lymph node biopsy technique representa milestone in the planning of the surgical management of primary skin cancers.Lymphatic mapping and sentinel lymph node biopsy are used to identifyregional nodal micro metastases. This method help to differentiate the patients withpositive sentinel node that require complete lymph node dissection and possibleadjuvant therapy from those with negative sentinel node, avoiding them from morbidityof further treatments.Our aim in this retrospective study was to detect the efficiacy of this method inour clinic. For this, retrospective analysis of 71 patients, who were treated for skincancers ( 50 malign melanoma %70.4, 21 squamous cell carcinoma %29.6) in our clinicbetween the January of 2004 and March of 2007 in our clinic. These cases weremanaged after excision and histological analysis of the sentinel lymph node, whoselocalisation was detected by means of lymphoscintigraphy examination and anintraoperative gamma probe. The patients were evaluated according to the age, sex,localization of the lesion, histological type and level, and nodal status. The increase ofprobability in the low age, male sexuality, deep, ulcereted and head and neck localizedlesions was determined. Regional lymph node dissection was performed in 22 cases(%31), who had regional node micro metastasis. Node biopsy was performed solely forthe remaining (%69) cases, in other words this method avoidied these cases from thefurther therapy modalities.Sentinel lymph node biopsy represents a significant advantage as a minimallyinvasive procedure that provides the most important prognostic information for thepatients with skin cancers and helps to avoid the unnecessary surgical procedures withhigh morbidity in some cases.Key Words: Skin cancers, sentinel lymph node biopsy, lymphoscintigraphy,gamma probeI