A F Kovács1, H Walendzik, N Döbert, C Menzel. 1. Klinik und Poliklinik für Kiefer- und Plastische Gesichtschirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt am Main. A.Kovacs@em.uni-frankfurt.de
Abstract
BACKGROUND: The excision of sentinel lymph nodes has a growing relevance in the diagnosis of oral and oropharyngeal cancer in cases of N0 necks. The validity of sentinel node biopsy (SNB) was examined as a single surgical staging tool. PATIENTS AND METHODS: Within the framework of a multi-modal treatment scheme, SNB without elective neck dissection was carried out on 70 previously untreated patients in the same session as the surgery for the primary cancer. Control of accuracy was via observation of the manifestation of neck node metastases in 45 patients who were postoperatively irradiated. RESULTS: A total of 94% of sentinel nodes could be excised; 9 patients (13%) had positive nodes and were treated with a therapeutic neck dissection (ND). There were 2 neck node metastases as second primaries, all other patients remained regionally inconspicuous (median observation time 26 months). CONCLUSION: As a staging tool for N0 necks and T1-3 tumors, SNB could lead to a considerable reduction in the number of elective NDs. It could be well integrated into a multi-modal treatment scheme.
BACKGROUND: The excision of sentinel lymph nodes has a growing relevance in the diagnosis of oral and oropharyngeal cancer in cases of N0 necks. The validity of sentinel node biopsy (SNB) was examined as a single surgical staging tool. PATIENTS AND METHODS: Within the framework of a multi-modal treatment scheme, SNB without elective neck dissection was carried out on 70 previously untreated patients in the same session as the surgery for the primary cancer. Control of accuracy was via observation of the manifestation of neck node metastases in 45 patients who were postoperatively irradiated. RESULTS: A total of 94% of sentinel nodes could be excised; 9 patients (13%) had positive nodes and were treated with a therapeutic neck dissection (ND). There were 2 neck node metastases as second primaries, all other patients remained regionally inconspicuous (median observation time 26 months). CONCLUSION: As a staging tool for N0 necks and T1-3 tumors, SNB could lead to a considerable reduction in the number of elective NDs. It could be well integrated into a multi-modal treatment scheme.
Authors: A J Bilchik; A Giuliano; R Essner; P Bostick; P Kelemen; L J Foshag; S Sostrin; R R Turner; D L Morton Journal: Cancer J Sci Am Date: 1998 Nov-Dec