Sentinel lymphonodectomy in non-melanoma skin cancers

There are various types of non-melanoma skin cancers with an increased risk of local recurrence and metastasis. Metastases from non-melanoma skin cancer most frequently spread to the regional nodal basins, and the presence of nodal involvement carries a poor prognosis. Determination of nodal status is essential for the prognosis and management of these patients. Whereas extensive literature has shown the major role of sentinel lymphonodectomy in the management of malignant melanoma, experience with this procedure in non-melanoma skin cancers is fairly limited. We report on 10 selected patients with high-risk non-melanoma skin cancer, managed with sentinel lymphonodectomy. A metastatic sentinel lymph-node was found in 1 patient with recurrent cutaneous squamous cell carcinoma and in 1 patient with Merkel cell carcinoma. No false-negative results were observed. Previous reported data and our experience provide evidence that sentinel lymphonodectomy is a feasible and minimally invasive staging procedure also in patients with high-risk non-melanoma skin cancer. In particular, the technique is capable of selecting patients with nodal micrometastases, who can be submitted to completion lymphadenectomy, avoiding the morbidity of elective lymphadenectomy in patients with negative sentinel lymph-nodes.