Sentinel node detection in N0 cancer of the pharynx and larynx

Werner, Jochen A.; Dünne, Anja A.; Ramaswamy, Annette; Folz, Benedikt J.; Lippert, B. M.; Moll, Roland; Behr, T.

doi:10.1038/sj.bjc.6600445

Cited by 86 publications

(46 citation statements)

References 26 publications

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“…These results are comparable to the findings of other groups also applying radiological criteria for staging (Stoeckli et al, 2001;Barzan et al, 2002;Werner et al, 2002a). The better the staging methods are in detecting small metastases, the less occult metastases will be overlooked and the more valuable will be the impact of an additional sentinel lymph-node procedure.…”

Section: Discussionsupporting

confidence: 86%

“…Zitsch et al (2000) adopted a definition used in malignant melanomas defining the sentinel node as having two times the background activity count rate. Werner et al (2002a) characterised sentinel lymph nodes as the three nodes with the highest activity emitting at least 10 times the background counts. As depicted in Table 2, all sentinel lymph nodes with occult metastases were among the five nodes with the highest activity.…”

Section: Discussionmentioning

confidence: 99%

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Sentinel lymph-node biopsy in head and neck cancer

et al. 2004

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The aim of the study was to assess the diagnostic value of the sentinel node method in patients suffering from squamous cell carcinoma of the upper aerodigestive tract. In 50 patients with oral, pharyngeal or laryngeal carcinomas staged N0 up to 50 MBq technetium-99m colloid were injected peritumorally. Sentinel nodes were localised using a g-probe in the setting of an elective neck dissection. Pathological findings of sentinel nodes and corresponding neck specimens were compared. In 46 patients sentinel nodes were detected. Of these 34 patients were free of metastatic disease in the sentinel nodes and in the neck specimens. In 12 patients clinically occult metastases were found in the sentinel nodes. Three metastases were detected only after additional sectioning of the sentinel nodes. In four patients, a sentinel lymph node could not be localised. Our results support the sentinel node concept in head and neck cancer and a definition of the sentinel nodes as the three nodes with the highest activity. Careful clinical staging of the neck and thorough pathological evaluation of the sentinel nodes are necessary to avoid false-negative results.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Sentinel lymph-node biopsy in head and neck cancer

et al. 2004

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“…They are characterized by their early predominantly lymphatic metastatic spread (1,2). For over 30 years now, there was no significant improvement of the patient survival time regardless of new developments in surgical techniques as well as in the chemo(radio)therapy treatment scheme of this tumor entity.…”

mentioning

confidence: 99%

Reduced Cisplatin Sensitivity of Head and Neck Squamous Cell Carcinoma Cell Lines Correlates with Mutations Affecting the COOH-Terminal Nuclear Localization Signal of p53

Mandic

Schamberger²,

Müller

et al. 2005

Clinical Cancer Research

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Purpose: Head and neck squamous cell carcinomas (HNSCC) are the most frequent malignancies of the upper aerodigestive tract. Cisplatin resistance is a major problem in the treatment of a large number of HNSCC cancer patients. In this study, nine randomly selected HNSCC cell lines were investigated regarding expression, presence of mutations, nucleocytoplasmic distribution of p53, and sensitivity to cisplatin. Experimental Design: Protein expression was evaluated by Western blot analysis. The whole open reading frame of p53 was determined by reverse transcription-PCR sequencing. Nucleocytoplasmic distribution was evaluated by confocal laser scanning microscopy. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide viability assay was used to test for cisplatin sensitivity. Results: p53 mutations were found in all nine investigated HNSCC cell lines. Nuclear p53 signal was detected in six cell lines, whereas three cell lines exhibited total loss of nuclear p53 signal. Nuclear signal depended on the presence or absence of the COOH-terminal nuclear localization signal in p53. Cisplatin sensitivity was highly reduced in the group with loss of nuclear p53 signal compared with those with detectable nuclear signal. Transfection of wild-type and mutant p53 into a rat embryonic cell system showed highly reduced activity of the nuclear localization signal mutant p53 protein.Conclusion: Taken together, these data suggest that ''loss of nuclear p53 signal''correlates with cisplatin resistance in HNSCC. If these results can be validated on a larger number of tumor samples, including fresh tumor tissues, it potentially could help in sparing a subgroup of HNSCC patients the side effects associated with unnecessary chemotherapy by identifying cisplatin nonresponders before chemotherapy induction. Head and neck squamous cell carcinomas (HNSCC) accountfor the vast majority (>90%) of malignancies found in the upper aerodigestive tract. They are characterized by their early predominantly lymphatic metastatic spread (1, 2). For over 30 years now, there was no significant improvement of the patient survival time regardless of new developments in surgical techniques as well as in the chemo(radio)therapy treatment scheme of this tumor entity. Despite successful surgical removal of the primary tumor, which can be achieved in most cases, a high number of patients already developed regional lymph node or distant metastases at the time of diagnosis. The treatment scheme of this head and neck cancer, therefore, frequently includes additional surgery to remove tumorrelated lymph nodes (neck dissection) and postoperative chemo(radio)therapy or in the case surgery is not possible because of advanced tumor stage for example, primary chemo(radio)therapy. Postoperative survival of patients with regional lymph node or distant metastases then largely depends on the success of chemo(radio)therapy. Frequently, however, patients relapse after chemo(radio)therapy. Then, after having exhausted the full dose of local radiotherapy, chemo...

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“…The present analysis includes the 95% (1 782/1 874) of the patients in whom the treatment was primary radical intended radiotherapy (34 patients for various reasons had primary curatively intended surgery and 58 did not have curative treatment). Some patients (40) included in the present analysis did not receive a curative dose of radiotherapy, as for different reasons (concurrent disease, age, refusal, death) they did not complete the scheduled treatment.…”

Section: Methodsmentioning

confidence: 99%