With the increased experience with sentinel node technology in melanoma and breast cancer, investigators have begun to apply this technique to the staging of other solid neoplasms. Bilchik et al. reported their experience with the universal application of lymphatic mapping at the John Wayne Cancer Institute . The investigators evaluated their experience with lymphatic mapping in Merkel cell tumors, squamous cell carcinoma of the head and neck, thyroid cancer, gastrointestinal malignancies (including small bowel, pancreas, and colon primaries), and vulvar neoplasms. They found the technique to be feasible for solid tumors other than breast and melanoma. Lymphatic mapping may ultimately replace conventional dissection with more accurate staging. Other investigators have confirmed the feasibility of the technique in colon and oral squamous cell carcinoma [27,28]. However, there have been no larger prospective studies in malignancies other than melanoma and breast cancer. At this point, the use of lymphatic mapping in other solid neoplasms should be considered investigational and should only be performed in the context of a clinical trial. These applications are not yet appropriate for transfer to the community setting.
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