[Detection of the sentinal node by lymphoscintigraphy in squamous-cell carcinoma of the oral cavity: a prospective study of 31 patients].
BACKGROUND
This study aimed at evaluating the relevance of sentinel node detection by lymphoscintigraphy in patients diagnosed with squamous-cell carcinoma of the oral cavity in the absence of neck adenopathy.


METHODS
A prospective study was carried out in 31 patients diagnosed with T1 to T3 squamous-cell carcinoma of the oral cavity without any clinically detectable neck adenopathy. A lymphoscintigraphy was performed the day before surgery. All patients underwent sentinel lymph node biopsy guided by a gamma-ray detecting probe and modified neck dissection. Pathologic evaluation of the sentinel lymph node included, in addition to the standard protocol, immunohistochemical analysis and thin sections of E stained preparations.


RESULTS
In 3 patients, the lymphoscintigraphy failed to detect any sentinel lymph node. In the remaining group of 28 patients, 20 patients showed a negative sentinel node concordant with a histologically negative neck dissection. In 5 patients, a positive lymph node was found although the rest of the neck dissection was negative. In 3 patients, sentinel lymph node was found to be negative but other neck nodes were positive. The overall sensitivity of lymphoscintigraphy in our study was 62%.


CONCLUSIONS
Surprisingly, the results of our study do not support the clinical usefulness of sentinel lymph node detection as a reliable and accurate staging method in patients with oral squamous cell carcinoma. We observed that lymphoscintigraphy was not a reliable method for detecting micrometastases in patients diagnosed with a squamous-cell carcinoma of the oral cavity without clinical evidence of neck matastases.
Collin
A-C
AC
Service de chirurgie Maxillo-faciale, CHU Lyon-Sud, Chemin Grand Revoyet, 69310 Pierre Bénite Cedex.
Girod
A
A
Pinet-Isaac
S
S
Boulétreau
P
P
Morelec
I
I
Céruse
P
P
Breton
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009333:Neck; D037981:Neck Dissection; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013669:Technetium Tc 99m Medronate
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate