Feasibility of the sentinel node biopsy in anal cancer

Aim. Anal cancer is a rare neoplasm. According to a European Organization for Research and Treatment of Cancer multivariate analysis, synchronous inguinal lymph node metastasis occurs in 10-25% of patients and constitutes an independent prognostic factor for local failure and overall mortality. Methods. Inguinal lymph node status was assessed using the sentinel node technique in 35 patients with anal cancer. Results. Histology revealed 23 squamous carcinomas, 10 basaloid carcinomas, 1 squamous carcinoma with basaloid areas and 1 spinocellular epithelioma associated with areas of Bowen's disease. Disease stage was T1 in 5 patients, T2 in 18, T3 in 11 and T4 in 1 patient. Lympho- scintigraphy using a GE Millennium gamma camera was performed after peritumoral injection of 37 MBq of 99m Tc colloid. Surgical sentinel node biopsy with a portable Scintiprobe MR 100 (Politech®, Carsoli, Italy) had a detection rate of 97.1%. Inguinal metastases were detected in 7 (20%) patients, in 2 of which metastasis was bilateral. Conclusion. Given the correlation between prognosis and node involvement, sentinel node biopsy can be con- sidered a simple method for adequate pretreatment staging of anal carcinoma. Use of the technique could avert the need for prophylactic inguinal radiotherapy in N0-N1 patients, thus reducing the morbidity associated with inguinal radiotherapy. Consistent follow-up is required to evaluate long-term results.