scholarly journals Prognosis of Early Stage Oral Squamous Cell Carcinoma Based on Sentinel Lymph node Biopsy for Diagnosis of Cervical Lymph Node Metastasis

2017 ◽  
Vol 30 (1) ◽  
pp. 89-94
Author(s):  
YUUDAI KONDO ◽  
KENTARO NAGAI ◽  
YURI TAGAWA ◽  
KOJI YAMAMOTO ◽  
YOSHIHIRO YAMASHITA
Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3055 ◽  
Author(s):  
Rutger Mahieu ◽  
Josanne S. de Maar ◽  
Eliane R. Nieuwenhuis ◽  
Roel Deckers ◽  
Chrit Moonen ◽  
...  

Sentinel lymph node biopsy (SLNB) is a diagnostic staging procedure that aims to identify the first draining lymph node(s) from the primary tumor, the sentinel lymph nodes (SLN), as their histopathological status reflects the histopathological status of the rest of the nodal basin. The routine SLNB procedure consists of peritumoral injections with a technetium-99m [99mTc]-labelled radiotracer followed by lymphoscintigraphy and SPECT-CT imaging. Based on these imaging results, the identified SLNs are marked for surgical extirpation and are subjected to histopathological assessment. The routine SLNB procedure has proven to reliably stage the clinically negative neck in early-stage oral squamous cell carcinoma (OSCC). However, an infamous limitation arises in situations where SLNs are located in close vicinity of the tracer injection site. In these cases, the hotspot of the injection site can hide adjacent SLNs and hamper the discrimination between tracer injection site and SLNs (shine-through phenomenon). Therefore, technical developments are needed to bring the diagnostic accuracy of SLNB for early-stage OSCC to a higher level. This review evaluates novel SLNB imaging techniques for early-stage OSCC: MR lymphography, CT lymphography, PET lymphoscintigraphy and contrast-enhanced lymphosonography. Furthermore, their reported diagnostic accuracy is described and their relative merits, disadvantages and potential applications are outlined.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5584-5584
Author(s):  
Hiroyuki Goda ◽  
Koh-ichi Nakashiro ◽  
Ryota Oka ◽  
Satoru Shintani ◽  
Hiroyuki Hamakawa

5584 Background: Regionallymph node metastasis is an important prognostic factor in oral squamous cell carcinoma (OSCC). Sentinel lymph node biopsy (SLNB) is a widely accepted procedure in various human malignancies. In clinically N0 (cN0) OSCC cases, SLNB has received considerable attention for its role in deciding whether to perform neck dissection. In this study, we assessed the efficiency of SLNB for cN0 OSCC case in a single-institution experience. Methods: 100 patients with cN0 OSCC underwent SLNB between 2001 and 2011, of which 95 were clinically T1 and T2. The primary site was tongue, gingiva, oral floor, buccal mucosa, and lip in 50%, 36%, 8%, 5%, and 1%, respectively. The location of sentinel lymph node (SLN) was determined by radioisotope (RI) method with preoperative lymphoscintigraphy and intraoperative use of a handheld gamma probe and/or dye method, and evaluated by histopathological examination and genetic analysis. Results: SLNB was performed with RI and dye method (79%), only dye method (14%), or only RI method (7%). SLN was successfully identified with RI method (100%) and dye method (71%). The average number of SLN was 2.5 with dye method and 1.9 with RI method. The rate of SLN identified side was 84% in ipsilateral, 10% in bilateral, and 6% in contralateral. Fifteen of 100 patients (15%) had metastasis-positive SLN, and 3 patients was up-grade to stage III and others to stage IVA. Eight patients with negative SLN developed latent neck lymph node metastasis. The sensitivity, specificity, accuracy, and negative predictive value was 65% (15/23), 100% (77/77), 92% (92/100) and 91% (77/85). Disease specific survival rate for SLNB-negative patients were 98% (79/81), and for SLNB-positive patients were 73% (11/15), respectively. Conclusions: SLNB is a minimally invasive and highly reliable means of staging the cN0 neck for patients with OSCC. Patients with negative SLNB showed more excellent neck control rate and SLNB provides more accurate staging than elective neck dissection or wait and see.


Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1231
Author(s):  
Christian Doll ◽  
Claudius Steffen ◽  
Holger Amthauer ◽  
Nadine Thieme ◽  
Thomas Elgeti ◽  
...  

Neck management in patients with early-stage, clinically node-negative oral squamous cell carcinoma (OSCC) remains a matter of discussion. Sentinel lymph node biopsy (SLNB) represents a treatment alternative to avoid elective neck dissection (END) in this cohort and different protocols and tracers exist. Here we present the clinical outcome of SLNB using 99mTc-tilmanocept in a two-day protocol in patients suffering from early-stage OSCC. A total of 13 patients (males: 6; females: 7; mean age: 65.7 years, ranging from 47 to 89 years) were included in this study. Most of the patients suffered from an OSCC of the floor of mouth (n = 6), followed by tongue (n = 5) and upper alveolar crest/hard palate (n = 2). Sentinel lymph nodes (SLNs) were successfully identified in all cases (range: 1–7). The average length of hospital stay was 4.7 days (range: 3–8 days) and mean duration of surgical intervention was 121 min (range: 74–233 min). One patient who suffered from an OSCC of the tongue was sentinel lymph node positive (SLN+). The mean follow-up for all sentinel lymph node negative (SLN-) patients (n = 12) was 20.3 months (range: 10–28 months). No local or nodal recurrences were observed within the observation period. In our patient cohort, SLNB using 99mTc-tilmanocept in a two-day protocol proved to be a reliable and safe staging method for patients suffering from early-stage, clinically node-negative OSCC. These results and their possible superiority to colloid tracers have to be confirmed in a prospective randomized controlled study.


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