Reliability of sentinel node technique in the treatment of N0 supraglottic laryngeal cancer.
OBJECTIVE
To study the reliability of the sentinel node technique (SNT) in the management of the N0 neck in patients with supraglottic laryngeal cancer.


METHODS
Patients presenting to our department, between 2001 and 2004, with T1-T3 supraglottic cancer and N0 neck, clinically and radiologically, were included in the study. All patients underwent sentinel lymph node detection, using the hand-held gamma probe followed by bilateral modified radical neck dissection (MRND) and resection of the primary tumor. We compared the results of the SNT with those of the gold standard MRND for the staging of the neck. The histologic examination was performed after fixation for both the products of SNT and MRND.


RESULTS
Twenty-nine patients were included in the study. Twenty-one had T2, 2 had T1, and 6 had T3 tumors. Patients had transoral CO(2) laser-assisted resection of the primary tumor. All the patients underwent bilateral neck dissection immediately after the sentinel node biopsy. Of the 95 sentinel lymph nodes harvested, 22 were positive for lymph node metastasis. The mean number of sentinel node per patient was 3. Of the 58 modified neck dissections (2 neck sides/patient), there was 1 additional positive lymph node, in the prelaryngeal area, and the patient had already positive sentinel lymph nodes. The SNT allowed the identification of node metastasis in 100% of the cases with a sensitivity of 100 (48-100), specificity of 78 (64-88), negative predictive value of 100 (91-100).


CONCLUSIONS
SNT is reliable in the staging of the clinically N0 neck in patients with supraglottic cancer.
Department of Otolaryngology, Head, and Neck Surgery, Catholic University of Louvain at Mont-Godinne, Yvoir, Belgium.
Georges
G
Lawson
Nayla
N
Matar
Marie-Cécile
MC
Nollevaux
Jacques
J
Jamart
Bruno
B
Krug
Monique
M
Delos
Marc
M
Remacle
Thierry Vander
TV
Borght
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging; D011379:Prognosis; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods