Oral Cavity Squamous Cell Carcinoma and the Clinically N0 Neck: The Past, Present, and Future of Sentinel Lymph Node Biopsy

Coughlin, Andrew; Resto, Vicente A.

doi:10.1007/s11912-010-0090-7

Cited by 50 publications

(40 citation statements)

References 46 publications

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“…This cannot be studied by the SLNB [20]. c) Sentinel lymph node biopsy at two or more level requires general anaesthesia, operating time and cervical dissection, thus offering little benefit over selective neck dissection [7,21,22].…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Localization Using 1 % Isosulfan Blue Dye in Cases of Early Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Sangwan¹,

Nilakantan

Patnaik³

et al. 2014

Indian J Otolaryngol Head Neck Surg

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To study the use of 1 % isosulfan blue dye in identifying sentinel node, sensitivity and specificity of frozen section and predictive value of sentinel node in predicting other nodal status in the cases of oral cavity and oropharyngeal squamous cell carcinoma. 15 patients of oral cavity and oropharyngeal SCC with clinically N0 neck, who required WLE of the primary lesion as well as neck dissection as per recommended treatment protocol, were selected from OPD. 1 % Isosulfan dye was injected peritumorally intraoperatively after the induction of general anaesthesia. Neck dissection was performed and first node taking up the blue dye was identified, dissected, removed and was sent for frozen section. In two of the 15 cases a sentinel node was identified (sensitivity of the technique-13 %). Both the sentinel nodes were positive for presence of metastasis on final histopathology (specificity-100 %). However, five cases had nodal metastasis on final histopathological examination of the neck dissection specimen (sensitivity of sentinel lymph node biopsy-40 %). Frozen section examination had a sensitivity and specificity of 100 %. All data was analyzed using SPSS 16 software. Use of 1 % Isosulfan Dye for identification of sentinel node is a simple and cheap technique, however, it has low sensitivity as compared to the use of triple diagnostic procedure consisting of lymphoscintigraphy, per op gamma probe localization and using isosulfan dye for sentinel node identification. Sentinel lymph node is representative of nodal status and correlates well with the final histopathological examination of the dissected neck nodes.Keywords Sentinel node Á N0 neck Á Isosulfan blue dye Á Frozen section Á SLNB (sentinel lymph node biopsy)

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Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Localization Using 1 % Isosulfan Blue Dye in Cases of Early Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Sangwan¹,

Nilakantan

Patnaik³

et al. 2014

Indian J Otolaryngol Head Neck Surg

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“…Analysis of the SLN for the presence of tumour cells proved itself beneficial for clinically occult regional disease exposure and more precise staging. 4 It is generally agreed that if on pathology and/or immunohistochemistry the SLN turns out to be negative, the patient may be spared from the potential morbidity of the regional lymphoadenectomy and the status of SLN presents an accurate indication of the condition of the rest of the regional nodes. 5 Diseasepositive SLN are correlated with higher locoregional recurrence rates and a poor survival prognosis even in the presence of a therapeutic neck dissection and adjuvant therapy.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer—a pilot study

Gvetadze

Xiong

et al. 2017

Dentomaxillofacial Radiology

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Objectives: To assess the usefulness of contrast-enhanced ultrasound (CEUS) with peritumoral injection of microbubble contrast agent for detecting the sentinel lymph nodes for oral tongue carcinoma. Methods: The study was carried out on 12 patients with T1-2cN0 oral tongue cancer. A radical resection of the primary disease was planned; a modified radical supraomohyoid neck dissection was reserved for patients with larger lesions (T2, n 5 8). The treatment plan and execution were not influenced by sentinel node mapping outcome. The SonovueÔ contrast agent (Bracco Imaging, Milan, Italy) was utilized. After detection, the position and radiologic features of the sentinel nodes were recorded. Results: The identification rate of the sentinel nodes was 91.7%; one patient failed to demonstrate any enhanced areas. A total of 15 sentinel nodes were found in the rest of the 11 cases, with a mean of 1.4 nodes for each patient. The sentinel nodes were localized in: Level IA-1 (6.7%) node; Level IB-11 (73.3%) nodes; Level IIA-3 (20.0%) nodes. No contrastrelated adverse effects were observed. Conclusions: For oral tongue tumours, CEUS is a feasible and potentially widely available approach of sentinel node mapping. Further clinical research is required to establish the position of CEUS detection of the sentinel nodes in oral cavity cancers. Dentomaxillofacial Radiology (2017Radiology ( ) 46, 20160345. doi: 10.1259 Cite this article as: Gvetadze SR, Xiong P, Lv M, Li J, Hu J, Ilkaev KD, et al. Contrastenhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer-a pilot study.

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“…33 The techniques and methodology for SLN identification in head and neck cancers have been widely debated and are still under investigation [ Tables 1 and 2]. 5,14,15,22,24,[27][28][29][30][31][34][35][36][37][38][39][40][41][42][43][44][45][46] Shoaib et al suggested a protocol involving preoperative lymphoscintigraphy, intraoperative blue dye and gamma probe localisation [ Figure 2]. 30 This technique is based on observing the route of lymphatic flow via imaging after the injection of a radioactive contrast agent near the primary tumour.…”

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confidence: 99%

“…30 This technique is based on observing the route of lymphatic flow via imaging after the injection of a radioactive contrast agent near the primary tumour. 42 The flow and direction of the lymph, comparable to the possibly metastatic flow from the tumour, can be visualised preoperatively by means of lymphoscintigraphy or single-photon emission computed tomography (SPECT). Lymphoscintigraphy reveals SLNs associated with the primary tumour, unexpected lymphatic drainage patterns and lymphatic vessels associated with different lymphatic drainage basins.…”

mentioning

confidence: 99%

Sentinel Lymph Node Biopsy: A new approach in the management of head and neck cancers

Sharma¹,

Koshy²,

Grover³

et al. 2017

SQUMJ

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‫شارما‬ ‫بوشان‬ ‫جروفر,‬ ‫سونال‬ ‫كوشي,‬ ‫جورج‬ ‫شارما,‬ ‫ديبيت‬ abstract: Cervical lymph node metastasis affects the prognosis and overall survival rate of and therapeutic planning for patients with head and neck squamous cell carcinomas (HNSCCs). However, advanced diagnostic modalities still lack accuracy in detecting occult neck metastasis. A sentinel lymph node biopsy is a minimally invasive auxiliary method for assessing the presence of occult metastatic disease in a patient with a clinically negative neck. This technique increases the specificity of neck dissection and thus reduces morbidity among oral cancer patients. The removal of sentinel nodes and dissection of the levels between the primary tumour and the sentinel node or the irradiation of target nodal basins is favoured as a selective treatment approach; this technique has the potential to become the new standard of care for patients with HNSCCs. This article presents an update on clinical applications and novel developments in this field. A s opposed to primary tumours, metastasis is responsible for the high mortality rate of most cancer patients; moreover, cancer cells primarily invade the regional lymph nodes before spreading to other parts of the body. Keywords1 Genetic instability results in tumour cell heterogeneity, leading to the emergence of metastatic clones and dissemination of the cancer from the primary tumour site.2 Malignant cells metastasise due to an interaction between the host factors and tumour cells. Genes related to the extracellular matrix, adhesion, motility and protease inhibition constitute a significant part of the metastatic process. The migration and invasion of cancer cells into the lymphatic system is governed by a variety of intricate genotypic, phenotypic and microenvironmental processes. After entering the lymphatic draining channels, the tumour cells metastasise to the regional lymph nodes in the neck and form the metastatic foci.4 Macrometastases refer to lymph nodes that appear suspicious on clinical or radiographical examinations; in contrast, nodal metastases-which are not detectable by imaging methods or physical examination-indicate occult or subclinical metastasis. Hermanek microscopically differentiated occult metastases into macrometastases (metastatic deposits of >2 mm), micrometastases (metastatic deposits of <2 mm) and isolated or small clusters of tumour cells (metastatic deposits of <0.2 mm).5 Isolated tumour cells (ITCs) can also be defined as a cluster of ≤200 tumour cells visible on one histology slide; these cells can further be categorised into those detectable by light microscopy, immunohistochemistry or molecular methods.6 Chemoradiation or elective neck dissection (END) should be considered in patients

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Oral Cavity Squamous Cell Carcinoma and the Clinically N0 Neck: The Past, Present, and Future of Sentinel Lymph Node Biopsy

Cited by 50 publications

References 46 publications

Sentinel Lymph Node Localization Using 1 % Isosulfan Blue Dye in Cases of Early Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Sentinel Lymph Node Localization Using 1 % Isosulfan Blue Dye in Cases of Early Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Contrast-enhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer—a pilot study

Sentinel Lymph Node Biopsy: A new approach in the management of head and neck cancers

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