Sentinel Lymph Node Biopsy for Cutaneous Squamous Cell Carcinoma of the Head and Neck
Indiana University
Summary
The purpose of this study is to research if a type of biopsy known as sentinel lymph node biopsy (SLNB) can help in determining the rate of tumor deposits that are hard to detect and identify in node-negative cutaneous squamous cell carcinoma of the head or neck.
Description
Nonmelanoma skin cancer is the most commonly diagnosed malignancy in the United States, with cutaneous squamous cell carcinoma (cSCC) representing about 20% of those cases. It is estimated that there are 700,000 patients diagnosed each year in the United States and the incidence has been increasing worldwide. Most tumors are found within the sun-exposed areas of the head and neck. The vast majority require only local treatment, however there is a subset of patients who present with regionally metastatic disease. Retrospective reviews have determined factors associated with recurrence, metastas…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Patients ≥ 18 years old at the time of informed consent * Ability to provide written informed consent and HIPAA authorization * Primary or recurrent invasive cutaneous squamous cell carcinoma of the head or neck, clinically staged T2-T4 based on AJCC staging * Clinically and radiographically regional node-negative (no evidence of regional lymph node metastasis or distant metastasis) * Able to undergo general anesthesia for sentinel lymph node biopsy * Able to undergo CT scan with contrast or MRI with contrast * Undergo surgical resection (Moh's or micrographic resection…
Interventions
- Proceduresentinel lymph node biopsy (SLNB)
Preoperative Lymphoscintigraphy: A standard injection of 2 mCi of 99m-Technetium sulfur colloid. Sequential immediate and delayed images will be obtained using SPECT/CT using a gamma probe. Ten-second counts will be done in areas of high activity to identify location of sentinel lymph node (SLN). After removal of the lymph node, a 10-second count will be done of the lymph node ex-vivo followed by 10-second count of the lymph node resection bed to ensure removal of SLN (less than 10% activity of LN). Surgical resection: Mohs micrographic surgery followed by SLNB. Intraoperative margins around the tumor will be confirmed through frozen section analysis. Patients with planned free flap reconstruction, will undergo SLNB with intraoperative, frozen section analysis. If lymph node is positive, immediate completion neck dissection will occur.
Location
- Indiana University Melvin & Bren Simon Cancer CenterIndianapolis, Indiana