New method of sentinel lymph node biopsy in transoral robotic surgery for oropharyngeal squamous cell carcinoma

Kulcsar, Marco Aurélio Vamondes; Canovas, Natasha Sobreira; Araújo-Neto, Vergilius José Furtado de; Kim, Jorge Du Ub; Cernea, Cláudio Roberto

doi:10.6061/clinics/2018/e550s

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…We describe for the first time a technique for injecting radiotracer into oropharyngeal tumors using an awake technique followed by lymphatic mapping with SPECT-CT. Previous reports of lymphoscintigraphy for sentinel lymph node assessment in OPSCC have focused exclusively on soft palate primary tumors, 22,23 likely due to the difficulty in obtaining satisfactory access to the tonsil and tongue base in awake patients. Our technique utilizes an effective simple topical anesthetic (Pacey's paste).…”

Section: Discussionmentioning

confidence: 99%

Lymphatic mapping with SPECT‐CT for evaluation of contralateral drainage in lateralized oropharyngeal cancers using an awake injection technique

et al. 2019

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Background: Risk of contralateral nodal metastases in oropharyngeal squamous cell carcinoma (OPSCC) is currently based on clinical risk factors. We propose lymphatic mapping with single photon emission computed tomography (SPECT-CT) for tumor-specific delineation of lymphatic drainage to guide treatment.Methods: Retrospective review of lymphatic drainage patterns in cT1-2 OPSCC and contralateral cN0 neck with a nonoperative, awake injection of 99 m-Tc sulfur colloid and SPECT-CT. Results: Ten patients were reviewed. Primary sites included tonsil (n = 8, 80%) and tongue base (n = 2, 20%). All patients tolerated awake injections with no complications. Nine patients (90%) demonstrated satisfactory migration of radiotracer to neck node(s) with seven (78%) to the ipsilateral lateral neck, one (11%) to the ipsilateral lateral neck and retropharynx, and one (11%) to bilateral lateral neck nodes.Conclusions: Characterization of lymphatic drainage in OPSCC is feasible using a nonoperative injection technique and SPECT-CT. Drainage to the contralateral neck is rare, warranting further study to tailor treatment appropriately. K E Y W O R D Sawake injection, lymphoscintigraphy, neck dissection, oropharyngeal squamous cell carcinoma, sentinel lymph node biopsy, SPECT-CT, transoral robotic surgery

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Section: Discussionmentioning

confidence: 99%

Lymphatic mapping with SPECT‐CT for evaluation of contralateral drainage in lateralized oropharyngeal cancers using an awake injection technique

et al. 2019

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“…Emerging evidence suggests there may be a role for sentinel lymph node biopsy (SLNBx) in head and neck cancer [37,38] . Kulcsar et al describe utilizing SLNBx for early-stage OPSCC with clinically N0 neck disease as a minimally invasive option [39] .…”

Section: Management Of the Neckmentioning

confidence: 99%

Role of transoral robotic surgery in the salvage setting: pitfalls and challenges

Stevens,

Kejner

2024

Plast Aesthet Res

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As rates of oropharyngeal squamous cell cancer (OPSCC) increase and patients survive longer, the number of patients with recurrence will also increase. Surgery is the primary tool for the management of locoregional recurrence when feasible, and transoral robotic surgery (TORS) techniques are a useful adjunct in effectively managing these cases. Careful patient selection, surgical planning, a thoughtful reconstructive plan, and postoperative supportive therapy are crucial for adequate oncologic and functional outcomes.

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Head and neck robotic surgery combined with sentinel lymph node biopsy. Fascinating, but feasible?

2020

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New method of sentinel lymph node biopsy in transoral robotic surgery for oropharyngeal squamous cell carcinoma

Cited by 3 publications

References 8 publications

Lymphatic mapping with SPECT‐CT for evaluation of contralateral drainage in lateralized oropharyngeal cancers using an awake injection technique

Lymphatic mapping with SPECT‐CT for evaluation of contralateral drainage in lateralized oropharyngeal cancers using an awake injection technique

Role of transoral robotic surgery in the salvage setting: pitfalls and challenges

Head and neck robotic surgery combined with sentinel lymph node biopsy. Fascinating, but feasible?

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