[Sentinel lymph node excision. Treatment method of the N0 neck in patients with oral and oropharyngeal carcinoma]

HNO. 2001 Aug;49(8):646-53. doi: 10.1007/s001060170063.
[Article in German]

Abstract

Background: The clinically non-metastatic neck is an unsolved problem in the treatment of oral and oropharyngeal squamous cell carcinomas. A rational procedure is looked for which is neither exaggerated nor neglects the needed safety.

Patients and methods: 15 patients with primary squamous cell carcinomas of the oral cavity and the oropharynx, staging T1-4N0M0 were examined. After peritumoral intramucodermal injection of tc99m-labeled colloidal albumin the lymphoscintigraphy using gamma-camera imaging prior and hand-held gamma-probe during operation were used for identification of the nodes. Selective sentinel lymph node exstirpation was followed by radical tumor resection.

Results: In all cases (n = 41) lymph nodes could be detected, 40 of them were sentinel lymph nodes, distributed to all neck levels, in 5 cases bilateral drainage. 92.5% of sentinel lymph nodes could be actually removed. All but 1 (97.5%) were true-negative. In the positive case modified radical neck dissection harvested another affected node.

Conclusions: Methodically seen, the sentinel procedure works well and might lead to reduced post-surgical morbidity in about 50% of patients with oral cancer. To date, the procedure should be confined to studies with special requirements to diagnostics and subsequent treatment.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck Dissection
  • Neoplasm Staging
  • Otorhinolaryngologic Neoplasms / pathology*
  • Otorhinolaryngologic Neoplasms / surgery
  • Prognosis
  • Sentinel Lymph Node Biopsy*