[Studies on significance of sentinel lymphadenectomy in pharyngeal and laryngeal carcinoma].
BACKGROUND
Management of the suspected N0-neck (sonography and CT) in squamous cell carcinoma (SCC) of the head and neck is discussed controversially. The question arises whether the sentinel node (SN) concept as it is performed in different areas of clinical oncology is applicable to ear, nose, and throat medicine.


METHODS
Nine male patients with SCC were studied (4 oropharynx, 2 hypopharynx, and 3 larynx) in whom different lymph node status was diagnosed clinically (5 x N0, 2 x N1, 2 x N2c). After intraoperative scintillation probe detection, the histological examination of the SN with neck dissection (ND) specimen followed.


RESULTS
In 7 of 9 cases SN detection was successful. In 4 of 5 cases of clinical N0 status, SN, and ND specimens were free of tumor histologically, while in one patient radiolabel-identified SN showed tumor cells in histological examination. In 2 patients with clinical N1 neck, SN, and ND were histologically tumor-free in one patient and contained one single tumor metastasis located in the SN in the other patient. In 2 patients with clinically and histologically proven N2c neck, lymph nodes located in regions II and III showed metastasis including capsular rupture. In both cases no lymph node radioactivity was detectable during the operation.


CONCLUSIONS
The results suggest that sentinel lymphonodectomy may be suited for ear, nose, and throat medicine. Before it is applied to clinical practice, further problems must be resolved. These include the short distance between the primary injection side and lymph nodes and the influence of intranodal tumor metastasis on the uptake of the radiolabeled tracer.
Werner
J A
JA
Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Philipps-Universität Marburg. j.a.werner@mailer.uni-marburg.de
Dünne
A A
AA
Brandt
D
D
Ramaswamy
A
A
Külkens
C
C
Lippert
B M
BM
Folz
B J
BJ
Joseph
K
K
Moll
R
R
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D010610:Pharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D011877:Radionuclide Imaging