title: Autologus groin lymph node transfer for “sentinel lymph network” reconstruction after head-and-neck cancer resection and neck lymph node dissection: a case report.
abstract: Local or distant metastatic recurrence after therapy is observed in 20–30% of cases of head-and-neck cancer. An unfavorable course may occur after cervical lymph node dissection due to loss of immunoprotective lymph nodes in the head-and-neck region. To overcome this problem, we performed autologous lymph node transplantation from the groin after head-and-neck cancer resection and cervical lymph node dissection. The patient was a 63-year-old man with squamous cell carcinoma in the mesopharyngeal lateral wall. After tumor resection and right cervical lymph node dissection, a lymph node-containing superficial circumflex iliac artery perforator flap was transplanted from the left groin. Pathological examination showed that cancer had invaded the primary tumor tissue stump. Thus, radiotherapy (66 Gy) was performed for the residual tumor from days 28 to 84 after surgery. At 12 months after surgery, no recurrent lesion or has developed. The biopsy of flap and lymphatic vessel endothelial hyaluronan receptor-1 (LYVE1) immunostaining shows creditable lymph network in the flap, compared with normal free flap. This case suggests that autologous lymph node transplantation may keep watch on cancer recurrence by reconstruction of the lymph node system in the resected region, and we suggest that this approach may be very useful in cancer therapy.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Tokyo,Tokyo, Japan. mihara@keiseigeka.name
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Mitsunaga
authors.initials: M
authors.lastname: Narushima
authors.forename: Shinya
authors.initials: S
authors.lastname: Hayami
authors.forename: Naoya
authors.initials: N
authors.lastname: Sawamoto
authors.forename: Munekazu
authors.initials: M
authors.lastname: Naito
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006119:Groin / Q000473:pathology / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D021701:Sentinel Lymph Node Biopsy; D013524:Surgical Flaps / Q000098:blood supply*; D014182:Transplantation, Autologous; D016896:Treatment Outcome