Paola De Nardi1, Massimiliano Mistrangelo2, Giovanni Burtulo1, Paolo Passoni3, Najla Slim3, Monica Ronzoni4, Carla Canevari5, Danilo Parolini1, Luca Massimino6, Pierfrancesco Franco7, Paola Cassoni8, Adriana Lesca9, Valentina Testa2, Riccardo Rosati1. 1. Department of Gastrointestinal Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy. 2. Department of Surgical Science, Città dalla Salute e della Scienza, University of Turin, Turin, Italy. 3. Department of Radiotherapy, IRCCS San Raffaele Scientific Institute, Milan, Italy. 4. Department of Oncological, IRCCS San Raffaele Scientific Institute, Milan, Italy. 5. Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy. 6. Laboratory of Immunopathology in Gastroenterology, Humanitas University, Milan, Italy. 7. Department of Oncology and Radiation Oncology, Città dalla Salute e della Scienza, University of Turin, Turin, Italy. 8. Department of Biomedical Sciences and Human Oncology, Pathology Unit, Città della Salute e della Scienza, University of Turin, Turin, Italy. 9. Department of Radiology, Nuclear Medicine Unit, Città della Salute e della Scienza, Turin, Italy.
Abstract
BACKGROUND AND OBJECTIVES: The aim of our study was to analyze the results of selective inguinal node irradiation in patients with anal cancer, based on the biopsy of the inguinal sentinel lymph node (SLN), in terms of local control and prognosis. METHODS: Records of patients with anal squamous cell carcinoma from January 2001 to December 2016 were retrospectively reviewed. Tc99 lymphoscintigraphy was performed in all the clinically inguinal negative patients, followed by radio-guided surgical removal of the inguinal SLN. All patients were treated with combined radiochemotherapy. In patients with negative sentinel nodes, the inguinal area was excluded in the radiotherapy field. RESULTS: A total of 123 patients, 76 females (61.8%), mean age 60.1 ± 12.19 years old, underwent intraoperative lymph node retrieval. The histological analysis showed metastasis in the SLN in 28 patients (22.8%). The mean follow-up was 43.44 ± 31.86 months. No inguinal recurrence was observed in patients with negative inguinal sentinel node(s). A statistically significant difference was observed for overall and disease-free survivals in a patient with positive and negative inguinal sentinel nodes. CONCLUSIONS: In patients with anal canal cancer, the exclusion of the inguinal regions from the radiotherapy field, in patients with negative SLN, does not compromise locoregional control nor prognosis.
BACKGROUND AND OBJECTIVES: The aim of our study was to analyze the results of selective inguinal node irradiation in patients with anal cancer, based on the biopsy of the inguinal sentinel lymph node (SLN), in terms of local control and prognosis. METHODS: Records of patients with anal squamous cell carcinoma from January 2001 to December 2016 were retrospectively reviewed. Tc99 lymphoscintigraphy was performed in all the clinically inguinal negative patients, followed by radio-guided surgical removal of the inguinal SLN. All patients were treated with combined radiochemotherapy. In patients with negative sentinel nodes, the inguinal area was excluded in the radiotherapy field. RESULTS: A total of 123 patients, 76 females (61.8%), mean age 60.1 ± 12.19 years old, underwent intraoperative lymph node retrieval. The histological analysis showed metastasis in the SLN in 28 patients (22.8%). The mean follow-up was 43.44 ± 31.86 months. No inguinal recurrence was observed in patients with negative inguinal sentinel node(s). A statistically significant difference was observed for overall and disease-free survivals in a patient with positive and negative inguinal sentinel nodes. CONCLUSIONS: In patients with anal canal cancer, the exclusion of the inguinal regions from the radiotherapy field, in patients with negative SLN, does not compromise locoregional control nor prognosis.