Sentinel node biopsy as staging tool in a multimodality treatment approach to cancer of the oral cavity and the oropharynx.
OBJECTIVE
Feasibility of sentinel lymph node (SLN) biopsy in head and neck cancer as a staging tool embedded in a multimodality regimen including neoadjuvant intraarterial chemotherapy.


METHODS
39 patients with oral and anterior oropharyngeal cancer classified N0 by [18 F]FDG-PET underwent SLN scintigraphy. Selective SLN biopsy without elective neck dissection (ND) was performed, immediately followed by radical resection of the primary tumor. Histopathology included step-serial sections and immunocytochemistry.


RESULTS
Lymphoscintigraphy detected 104 spots. In 15 patients there was bilateral drainage. 114 SLN were excised due to additional intraoperative discrimination. 95% of visualised SLN could be removed. Histology was positive in 3 patients (8%), all underwent ND which yielded another positive node in 2 cases. Median observation time was 30 months. Two patients (5%) had a neck relapse in combination with a second primary.


CONCLUSIONS
SLN biopsy as only surgical staging tool seems to be feasible.


CONCLUSIONS
Method promises reduction of elective ND and morbidity in N0 patients.
Kovács
Adorján F
AF
Clinic for Maxillofacial Plastic Surgery, Johann Wolfgang Goethe University Medical School, Frankfurt am Main, Germany. A.Kovacs@em.uni-frankfurt.de
Landes
Constantin A
CA
Hamscho
Nadja
N
Risse
Jörn H
JH
Berner
Uwe
U
Menzel
Christian
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D049268:Positron-Emission Tomography; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy; D014057:Tomography, X-Ray Computed