Sentinel lymph node radiolocalization and biopsy in oral cavity and oropharynx mucosal squamous cell carcinoma.

OBJECTIVES: The aims of the study were to assess our feasibility and accuracy of sentinel lymph node radiolocalization in patients with squamous cell carcinoma of the oral cavity and oropharynx, and to determine whether the pathology of the sentinel node reflected regional disease.

MATERIAL AND METHODS: Patients preoperatively underwent lymphoscintigraphy after peritumoral injection of a 99m Tc labeled radiocolloid. After perioperative gamma probe radiolocalization of the sentinel lymph nodes, elective neck dissection was performed. The histopathological examination of the sentinel nodes and other nodes of neck dissection specimen were compared.

RESULTS: Detection of sentinel lymph nodes by lymphoscintigraphy was feasible in all 12 patients. Also localization with a handheld gamma probe was successful in all patients. Forty sentinel nodes and 276 non-sentinel nodes were histopathologically examined. Occult metastases were confirmed in 7 sentinel nodes (4 patients). There was no false negative sentinel lymph node in our series.

CONCLUSION: Identification of the sentinel lymph node in patients with squamous cell carcinoma of the oral cavity and oropharynx is technically feasible and accurate. This method shows to be able to predict occult metastases and select patients who would benefit from neck dissection (Fig. 1, Tab. 2, Ref. 28). Full Text in free PDF www.bmj.sk.