Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-13T01:30:58.306Z Has data issue: false hasContentIssue false

Sentinel lymph node biopsy in node-negative squamous cell carcinoma of the oral cavity and oropharynx

Published online by Cambridge University Press:  17 September 2008

P Burns*
Affiliation:
Department of Otorhinolaryngology, Mater Hospital, Dublin, Ireland
A Foster
Affiliation:
Department of Radiology, Mater Hospital, Dublin, Ireland
P Walshe
Affiliation:
Department of Otorhinolaryngology, Mater Hospital, Dublin, Ireland
T O'Dwyer
Affiliation:
Department of Otorhinolaryngology, Mater Hospital, Dublin, Ireland
*
Address for correspondence: Mr Paul Burns, 31 Woodview, Blackrock, Co Dublin, Ireland. E-mail: pburns@rcsi.ie.

Abstract

Objectives:

Considerable controversy exists regarding the merits of elective neck dissection in patients with early stage oral cavity and oropharyngeal squamous cell carcinoma. It is highly desirable to have a method of identifying those patients who would benefit from further treatment of the neck when they are clinically node-negative. The purpose of the present study was to examine the use of sentinel lymph node biopsy in identifying occult neck disease in a cohort of patients with node-negative oral cavity and oropharyngeal squamous cell carcinoma.

Design:

We evaluated a total of 13 patients with oral cavity and oropharyngeal cancer who were clinically and radiologically node-negative.

Results:

A sentinel lymph node was found in all 13 patients, revealing metastatic disease in five patients, four of whom had one or more positive sentinel lymph nodes. There was one false negative result, in which the sentinel lymph node was negative for tumour whereas histological examination of the neck dissection specimen showed occult disease.

Conclusion:

In view of these findings, we would recommend the use of sentinel lymph node biopsy in cases of oral cavity and oropharyngeal squamous cell carcinoma, in order to aid the differentiation of those patients whose necks are harbouring occult disease and who require further treatment.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Irish Otolaryngological Society Meeting, 5–6 October 2007, Limerick, Ireland.

References

1 Alvi, A, Johnson, JT. Extracapsular spread in the clinically negative neck (N0): implications and outcome. Otolaryngol Head Neck Surg 1996;114:6570CrossRefGoogle ScholarPubMed
2 Sheahan, P, O'Keane, C, Sheahan, JN, O'Dwyer, TP. Effect of tumour thickness and other factors on the risk of regional disease and treatment of the N0 neck in oral squamous carcinoma. Clin Otolaryngol 2003;28:461–71CrossRefGoogle ScholarPubMed
3 Morton, DL, Wen, DR, Wong, JH, Economou, JS, Cagle, LA, Storm, FK et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;27:392399CrossRefGoogle Scholar
4 Morton, DL, Thompson, JF, Essner, R, Elashoff, R, Stern, SL, Nieweg, OE et al. Multicentre Selective Lymphadenectomy Trial Group. Validation of the accuracy of lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicentre trial. Ann Surg 1999;230:453–63CrossRefGoogle Scholar
5 McGuirt, WF, Johson, JT, Myers, EN, Rothfield, R, Wagner, R. Floor of mouth carcinoma: the management of the clinically negative neck. Arch Otolaryngol Head Neck Surg 1995;121:278–82CrossRefGoogle ScholarPubMed
6 Kligerman, J, Lima, RA, Soares, JR, Prado, L, Dias, FL, Freitas, EQ et al. Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of the oral cavity. Am J Surg 1994;168:391–4CrossRefGoogle Scholar
7 Persky, MS, Lagmay, VM. Treatment of the clinically negative neck in oral squamous cell carcinoma. Laryngoscope 1999;109:1160–4CrossRefGoogle ScholarPubMed
8 Cunningham, MJ, Johnson, JT, Myers, EM, Schramm, VL, Thearle, PB. Cervical lymph node metastases after local excision of early squamous cell carcinoma of the oral cavity. Am J Surg 1986;152:361–5CrossRefGoogle ScholarPubMed
9 Ross, GL, Shaoib, T, Soutar, DS, MacDonald, DG, Camilleri, IG, Bessent, RG et al. The First International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer and Adoption of a Multicenter Trial Protocol. Ann Surg Oncol 2002;9:406–10CrossRefGoogle ScholarPubMed
10 Ross, GL, Soutar, DS, MacDonald, DG, Shoaib, T, Camilleri, I, Roberton, AG et al. Sentinel node biopsy in head and neck cancer: preliminary results of a multicenter trial. Ann Surg Oncol 2004;11:690–6CrossRefGoogle ScholarPubMed
11 Stoeckli, SJ, Steinbert, H, Pfaltz, M, Schmid, S. Sentinel lymph node evaluation in squamous cell carcinoma of the head and neck. Otolaryngol Head Neck Surg 2001;125:221–6CrossRefGoogle ScholarPubMed
12 Alex, JC, Sasaki, CT, Krag, DN, Wenig, B, Pyle, PB. Sentinel lymph node radiolocalization in head and neck squamous cell carcinoma. Laryngoscope 2000;110:198203CrossRefGoogle ScholarPubMed
13 Albertini, JJ, Cruse, CW, Rapaport, D, Wells, K, Russ, M, DeConti, R et al. Intraoperative radiolymphoscintigraphy improves sentinel node identification for patients with melanoma. Ann Surg 1996;223:217–24CrossRefGoogle ScholarPubMed
14 Shoaib, T, Soutar, DS, MacDonald, DG, Camilleri, IG, Dunaway, DJ, Gray, HW et al. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer 2001;91:2077–833.0.CO;2-E>CrossRefGoogle ScholarPubMed
15 Kovacs, AJ, Dobert, N, Gaa, J, Menzel, C, Biller, R. Positron emission tomography in combination with sentinel node biopsy reduces the rate of elective neck dissections in the treatment of oral and oropharyngeal cancer. J Clin Oncol 2004;22:3973–80CrossRefGoogle ScholarPubMed