A F Kovács1, P Acker, U Berner, J H Risse. 1. Klinik und Poliklinik für Kiefer- und Plastische Gesichtschirurgie, Johann Wolfgang Goethe-Universität Frankfurt am Main. A.Kovacs@em.uni-frankfurt.de
Abstract
BACKGROUND: The clinically non-metastatic neck is an unsolved problem in the treatment of oral and oropharyngeal squamous cell carcinomas. A rational procedure is looked for which is neither exaggerated nor neglects the needed safety. PATIENTS AND METHODS: 15 patients with primary squamous cell carcinomas of the oral cavity and the oropharynx, staging T1-4N0M0 were examined. After peritumoral intramucodermal injection of tc99m-labeled colloidal albumin the lymphoscintigraphy using gamma-camera imaging prior and hand-held gamma-probe during operation were used for identification of the nodes. Selective sentinel lymph node exstirpation was followed by radical tumor resection. RESULTS: In all cases (n = 41) lymph nodes could be detected, 40 of them were sentinel lymph nodes, distributed to all neck levels, in 5 cases bilateral drainage. 92.5% of sentinel lymph nodes could be actually removed. All but 1 (97.5%) were true-negative. In the positive case modified radical neck dissection harvested another affected node. CONCLUSIONS: Methodically seen, the sentinel procedure works well and might lead to reduced post-surgical morbidity in about 50% of patients with oral cancer. To date, the procedure should be confined to studies with special requirements to diagnostics and subsequent treatment.
BACKGROUND: The clinically non-metastatic neck is an unsolved problem in the treatment of oral and oropharyngeal squamous cell carcinomas. A rational procedure is looked for which is neither exaggerated nor neglects the needed safety. PATIENTS AND METHODS: 15 patients with primary squamous cell carcinomas of the oral cavity and the oropharynx, staging T1-4N0M0 were examined. After peritumoral intramucodermal injection of tc99m-labeled colloidal albumin the lymphoscintigraphy using gamma-camera imaging prior and hand-held gamma-probe during operation were used for identification of the nodes. Selective sentinel lymph node exstirpation was followed by radical tumor resection. RESULTS: In all cases (n = 41) lymph nodes could be detected, 40 of them were sentinel lymph nodes, distributed to all neck levels, in 5 cases bilateral drainage. 92.5% of sentinel lymph nodes could be actually removed. All but 1 (97.5%) were true-negative. In the positive case modified radical neck dissection harvested another affected node. CONCLUSIONS: Methodically seen, the sentinel procedure works well and might lead to reduced post-surgical morbidity in about 50% of patients with oral cancer. To date, the procedure should be confined to studies with special requirements to diagnostics and subsequent treatment.
Authors: L W T Alkureishi; Z Burak; J A Alvarez; J Ballinger; A Bilde; A J Britten; L Calabrese; C Chiesa; A Chiti; R de Bree; H W Gray; K Hunter; A F Kovacs; M Lassmann; C R Leemans; G Mamelle; M McGurk; J Mortensen; T Poli; T Shoaib; P Sloan; J A Sorensen; S J Stoeckli; J B Thomsen; G Trifiro; J Werner; G L Ross Journal: Ann Surg Oncol Date: 2009-11 Impact factor: 5.344
Authors: Lee W T Alkureishi; Zeynep Burak; Julio A Alvarez; James Ballinger; Anders Bilde; Alan J Britten; Luca Calabrese; Carlo Chiesa; Arturo Chiti; Remco de Bree; Harry W Gray; Keith Hunter; Adorjan F Kovacs; Michael Lassmann; C Rene Leemans; Gerard Mamelle; Mark McGurk; Jann Mortensen; Tito Poli; Taimur Shoaib; Philip Sloan; Jens A Sorensen; Sandro J Stoeckli; Jorn B Thomsen; Giusepe Trifiro; Jochen Werner; Gary L Ross Journal: Eur J Nucl Med Mol Imaging Date: 2009-11 Impact factor: 9.236