Role of Sentinel Lymph Node Biopsy for Skin Cancer Based on Clinical Studies

SIMPLE SUMMARY: Sentinel lymph nodes are the first regional lymph nodes to receive lymph fluid from the primary cancer, sentinel lymph node biopsy (SLNB) can detect occult nodal metastasis. In addition, it may also have a therapeutic effect via regional disease control. SLNB was first introduced in melanoma among skin cancers and is currently used in many types of skin cancers. Previous randomized clinical trials suggested a prognostic benefit from SLNB in melanoma patients. However, whether SLNB affects the prognosis of patients with nonmelanoma skin cancer remains largely unknown, although SLNB may provide important information about nodal status. Since SLNB may be associated with adverse events including infection, lymphedema, and nerve injury, routine application of SLNB for all patients with skin cancer is not recommended. In this review, we summarize the evidence available in the literature regarding the role of SLNB in skin cancer. ABSTRACT: The sentinel lymph node is the first lymph node from the primary tumor. Sentinel lymph node biopsy (SLNB) is a surgical procedure that can detect occult nodal metastasis with relatively low morbidity. It may also have a therapeutic effect via regional disease control. The Multicenter Selective Lymphadenectomy-I (MSLT-I) trial revealed a prognostic benefit from SLNB in melanoma patients. However, it remains unclear whether there is a prognostic benefit from SLNB in patients with nonmelanoma skin cancer owing to a lack of randomized prospective studies. Nevertheless, SLNB provides important information about nodal status, which is one of the strongest factors to predict prognosis and may guide additional nodal treatment. Currently, SLNB is widely used in the management of not only patients with melanoma but also those with nonmelanoma skin cancer. However, the utilization and outcomes of SLNB differ among skin cancers. In addition, SLNB is not recommended for routine use in all patients with skin cancer. In this review, we provide a summary of the role of SLNB and of the indications for SLNB in each skin cancer based on previously published articles.