[Lymphatic mapping and sentinel node biopsy in squamous cell carcinoma of head and neck mucosa].
BACKGROUND
Lymphatic mapping with sentinel node biopsy (LMSNB) is a staging alternative in melanoma and breast cancer. In oral cavity cancer (OCC) without palpable nodes, the recommended surgical treatment is elective-selective neck dissection; nevertheless, 70% will not show metastasis. LMSNB might be a staging alternative. Our objective was to determine if this technique allows the identification of sentinel node.


METHODS
Characteristics were T1-2, N0, OCC patients >4 mm of tumor thickness. We injected 3 mCi of rhenium and 2 cc of blue dye around the tumor and performed a lymphogammagraphy. Sentinel node (SN) was identified by color and radioactivity, and all patients were submitted to suprahyoid dissection. Index of success, false negative, and negative predictive values were calculated.


RESULTS
Of 41 patients, there were 20 females and 21 males. Lymphogammagraphy showed a SN in each patient. SN was identified in all patients during surgery: in 10 patients the SN was "hot" (24%) and in 31 (75%) "hot and blue"; 13/41 (31.7%) showed metastasis, 4 had negative SN (false negative); in 3/13 metastatic SN. Diagnosis was made by definite analysis. All patients with false negative had tumors >2 cm.


CONCLUSIONS
LMSNB in oral cavity cancer has a high index of success and radical neck dissection could be avoided in 80% of patients with T1-2 tumors.
Gallegos-Hernández
José Francisco
JF
Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, IMSS, Av. Cuauhtémoc 330, Col. Doctores, 06725 México, D.F. gal61@prodigy.net.mx
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy