Background/Objectives: Sentinel Lymph Node Biopsy (SLNB) aims at identifying clinically occult nodal metastases. It is the standard staging procedure for patients with T1b to T4 primary cutaneous melanoma. Moreover, it is recommended whenever the risk of a positive SLNB is >5%, according to the National Comprehensive Cancer Network Melanoma guidelines. When considering Non-Melanoma Skin Cancer (NMSC), the SLNB could play a role in tumors that mainly spreads via lymphatics, but strong evidence is missing. In this paper, the hot topics and controversies are reviewed; Methods: A PRISMA systematic review was carried out on the PubMed (MEDLINE) library from 2004–2024, searching for studies on SLNB in NMSC; Results: Seventy articles and 6379 patients undergoing SLNB for Squamous Cell Carcinoma (SCC), Merkel Cell Carcinoma (MCC), and Porocarcinoma were included. Overall, the SLNB positivity rate in these NMSCs was 24.4%, with an SNLB detection rate of 97.6%. Specifically, the SLNB positivity rate was 12.3% for high-risk cutaneous SCC, 24.4% for anogenital SCC, 29.3% for MCC, and 30.6% for Porocarcinoma. Most papers concluded that SLNB is safe, feasible, and significant in these malignancies; Conclusions: SLNB should be discussed and offered to every patient with MCC, and it should be discussed and considered in “high risk” SCC and Porocarcinoma for staging and prognostic purposes, aiming to identify a subgroup of patients who may benefit the most from early treatments.
背景/目的：前哨淋巴结活检旨在识别临床隐匿性淋巴结转移，是T1b至T4原发性皮肤黑色素瘤患者的标准分期程序。根据美国国家综合癌症网络黑色素瘤指南，当前哨淋巴结活检阳性风险大于5%时即推荐实施。对于非黑色素瘤皮肤癌，前哨淋巴结活检可能对主要经淋巴途径扩散的肿瘤具有价值，但目前缺乏有力证据。本文综述了该领域的热点议题与争议；方法：遵循PRISMA原则，对PubMed（MEDLINE）数据库2004-2024年间非黑色素瘤皮肤癌前哨淋巴结活检研究进行系统综述；结果：共纳入70篇文献，涵盖6379例接受前哨淋巴结活检的鳞状细胞癌、默克尔细胞癌和汗孔癌患者。总体前哨淋巴结阳性率为24.4%，检出率达97.6%。具体而言，高危皮肤鳞状细胞癌阳性率为12.3%，肛门生殖器鳞状细胞癌为24.4%，默克尔细胞癌为29.3%，汗孔癌为30.6%。多数研究认为前哨淋巴结活检在这些恶性肿瘤中安全可行且具有重要价值；结论：应对所有默克尔细胞癌患者进行前哨淋巴结活检的讨论与实施，对于高危鳞状细胞癌和汗孔癌患者，也应基于分期与预后评估目的进行讨论与考量，以精准识别最能从早期治疗中获益的患者亚群。
Sentinel Lymph Node Biopsy: Is There a Role in Non-Melanoma Skin Cancer? A Systematic Review
肿瘤(癌症)患者之家