Abstract
Our objective was to determine the feasibility and accuracy of sentinel lymph node biopsy for patients with squamous cell carcinoma of the oral cavity with clinically N0 neck. Thirty one patients with previously untreated oral cavity squamous cell carcinoma without any clinically detectable neck metastases were enrolled into an open prospective trial between June 2003 and May 2007.
The sentinel lymph nodes were localized preoperatively by lymphoscintigraphy and intraoperatively by hand-held gamma-probe after peritumoral injection of Senti-Scint (Tc99m-labeled colloidal human serum albumin). An elective or therapeutic neck dissection was performed in 29 patients.
The histology of the sentinel lymph nodes was compared with the histology of the nodes in the neck dissections. The sentinel lymph nodes were identified by preoperative lymphoscintigraphy in 30 patients on 33 neck sides and intraoperatively by hand-held gamma-probe in 31 patients on 34 neck sides.
Occult metastases were found in 10 sentinel lymph nodes in 8 patients. The minimum follow-up of the patients in the study is 24 months.
The result of the sentinel lymph node biopsy was not false negative in any case. The sentinel lymph node biopsy correctly predicted the positivity and negativity of the necks in all 31 patients on 34 neck sides (100%).
The sentinel lymph node biopsy in patients with oral carcinomas is feasible and seems to accurately predict the status of the regional lymph nodes.