Sentinel node biopsy in oral cavity cancer: correlation with PET scan and immunohistochemistry.
BACKGROUND
Lymphoscintigraphy and sentinel node biopsy (LS/SNB) is a minimally invasive technique that samples first-echelon lymph nodes to predict the need for more extensive neck dissection.


METHODS
We evaluated this technique in 18 oral cavity cancers, stages T1-T3, N0. Patients underwent CT and positron emission tomography (PET) of the neck, followed by LS/SNB, frozen section, immediate selective neck dissection, definitive histology, and immunoperoxidase staining for cytokeratin. Histopathology of the sentinel node was correlated with that of the neck specimen.


RESULTS
There were 10 true positives: 6 identified on frozen section; 2 on permanent histology; and 2 only on immunoperoxidase staining. In six, the sentinel node was the only positive node. There were seven true negatives and one false negative.


CONCLUSIONS
Gross tumor replacement of lymph node architecture may obstruct and redirect lymphatic flow. Overall LS/SNB holds promise for oral cancer.
Civantos
Francisco J
FJ
Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136, USA.
Gomez
Carmen
C
Duque
Carlos
C
Pedroso
Felipe
F
Goodwin
William Jarrard
WJ
Weed
Donald T
DT
Arnold
David
D
Moffat
Fred
F
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D037981:Neck Dissection / Q000379:methods; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D014055:Tomography, Emission-Computed