Sentinel lymph node biopsy in node-negative squamous cell carcinoma of the oral cavity and oropharynx.
AffiliationDepartment of Otorhinolaryngology, Mater Hospital, Dublin, Ireland., email@example.com
Aged, 80 and over
Carcinoma, Squamous Cell/pathology/*secondary/surgery
Lymph Nodes/*pathology/radionuclide imaging
Sentinel Lymph Node Biopsy/*methods
Technetium Tc 99m Aggregated Albumin/diagnostic use
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CitationJ Laryngol Otol. 2009 Apr;123(4):439-43. Epub 2008 Sep 17.
JournalThe Journal of laryngology and otology
AbstractOBJECTIVES: 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.