title: Is there a role for sentinel node biopsy in early N0 tongue tumors?
abstract: BACKGROUND
  Detecting metastases to the cervical lymph nodes is the main problem in the management of squamous cell carcinoma of the tongue. We investigated the ability of sentinel node (SN) biopsy to predict neck status in 11 patients with lateral T1-T2, N0, and M0 squamous cell carcinoma of the tongue who underwent ipsilateral neck dissection 30 to 40 days after primary surgery.
  
  
  METHODS
  In 5 patients, technetium 99m-labeled particles were injected close to the operation scar on the day before neck dissection, and the labeled neck nodes were revealed by lymphoscintigraphy. The next 6 patients underwent lymphoscintigraphy both before surgery and before neck dissection. During neck dissection, the ipsilateral SNs were identified by using a hand-held probe and removed separately.
  
  
  RESULTS
  Three patients (27%) had metastatic neck nodes. In all cases, labeled nodes were revealed by scintigraphy. Ipsilateral SNs were removed from 8 patients and correctly predicted the state of the neck (6 negatives and 2 positives). Lymphoscintigraphy before and after surgery revealed that drainage was modified after surgery in 5 of 6 patients; the pre-surgery drainage pattern varied markedly among the 5 pN0 patients.
  
  
  CONCLUSIONS
  The technique allows easy and safe identification of SNs and shows promise in guiding selective neck dissection. Surgery on the primary tumor often modifies lymphatic drainage, so that SN biopsy may only be useful if the primary operation and neck dissection are performed at the same time.
authors.affiliation: Head and Neck Division, European Institute of Oncology, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Chiesa
authors.forename: S
authors.initials: S
authors.lastname: Mauri
authors.forename: C
authors.initials: C
authors.lastname: Grana
authors.forename: N
authors.initials: N
authors.lastname: Tradati
authors.forename: L
authors.initials: L
authors.lastname: Calabrese
authors.forename: M
authors.initials: M
authors.lastname: Ansarin
authors.forename: G
authors.initials: G
authors.lastname: Mazzarol
authors.forename: G
authors.initials: G
authors.lastname: Paganelli
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010865:Pilot Projects; D011877:Radionuclide Imaging; D014062:Tongue Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery