A preliminary study on sentinel lymph node biopsy: feasibility and predictive ability in oral cavity cancer

Abstract

The main factor that affects the prognosis of patients with head and neck cancer (HNC) is regional lymph node metastases. For this reason, the accurate evaluation of neck metastases is required for neck management. This study investigates the sentinel lymph node identification and the accuracy of the histopathology of the sentinel lymph node in patients with HNC. Eleven patients with histologically proven oral squamous cell carcinoma accessible to radiocolloid injection were enrolled in this study. Using both lymphoscintigraphy and a handheld gamma probe, the sentinel lymph node could be identified in all 11 patients. Subsequently, the sentinel lymph nodes and the neck dissection specimen were examined for lymph node involvement due to tumor. The histopathology of sentinel lymph nodes was consistent with the pathological N classification in all 11 patients. Furthermore, the histopathology of sentinel lymph nodes was superior to physical examination, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) scan. The results of this study indicate that sentinel lymph node identification is technically feasible and predicts cervical metastases in patients with oral cavity cancer. This may be a useful diagnostic technique for identifying lymph node disease in staging lymph node dissection.

How long the lymphoscintigraphy imaging should be continued for sentinel lymph node mapping?

“…It is now accepted that SLN biopsy is the method of choice for axillary lymph node staging in breast cancer [4][5][6]. This concept is also rapidly extending to other malignancies [7,8].…”

Is There a Need for Positron Emission Tomography Imaging to Stage the N0 Neck in T1-T2 Squamous Cell Carcinoma of the Oral Cavity or Oropharynx?

“…There was 1 false-benign node assessment in the total of 237 lymph nodes detected with the MRI scan (Table 3). 18 FDG-PET. No malignant lymph nodes were detected by 18 FDG-PET.…”

“…18 FDG-PET. No malignant lymph nodes were detected by 18 FDG-PET. One example of a false-negative result of lymph node metastases in the 18 FDG-PET scan is shown in Fig 2D. Four lymph nodes were detected and were truebenign on 18 FDG-PET: 3 lymph nodes in 1 patient with known sarcoidosis and 1 reactive lymph node.…”

Comparison between 18F-FDG PET (PET/CT) and sentinel lymph node biopsy in the detection of regional lymph node metastasis of various malignancies: review of the literature

“…In a study by Chikamatsu et al [48] , SLNB was used to detect lymphatic metastasis in oral cavity cancer compared with physical examination, CT, magnetic resonance imaging (MRI), and 18 F-FDG PET. Eleven patients with histologically proven oral squamous cell carcinoma were enrolled in the study.…”