Sentinel lymph node in carcinoma of the anal canal: A review

Aims To review the studies investigating the efficacy of the sentinel lymph node (SLN) procedure in anal canal carcinoma and to evaluate its potential role in guiding a more selective approach for patients with the malignancy. Methods A literature search in the PubMed database was preformed using the key words ‘sentinel lymph node’ and ‘anal cancer’. All indexed original articles (except case reports) on the SLN procedure in cancer of the anal canal were analysed. Results There are five published series to date. Eighty-four patients were studied. Rates of SLN detection and removal ranged from 66 to 100% of patients investigated. Nodal metastases were found in 7.1 to 42% of cases. No serious complications were reported. Conclusions The technique has proven to be safe and effective in sampling inguinal SLNs. The detection of occult metastases in clinically unsuspicious nodes represents an important improvement in the process of staging these patients, which has not been possible with any other method of diagnosis. Although SLN procedure is still in an early phase of investigation in this type of cancer, it emerges as an objective method to guide individual therapeutic decisions.