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Published on: July 25, 2011
Sentinel node biopsy in oral cavity cancer: correlation with PET scan and immunohistochemistry
Francisco J Civantos1, Carmen Gomez, Carlos Duque
1Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136, USA.
Background:
Lymphoscintigraphy and sentinel node biopsy (LS/SNB) is a minimally invasive technique that samples first-echelon lymph nodes to predict the need for more extensive neck dissection.
Methods:
We evaluated this technique in 18 oral cavity cancers, stages T1-T3, N0. Patients underwent CT and positron emission tomography (PET) of the neck, followed by LS/SNB, frozen section, immediate selective neck dissection, definitive histology, and immunoperoxidase staining for cytokeratin. Histopathology of the sentinel node was correlated with that of the neck specimen.
Results:
There were 10 true positives: 6 identified on frozen section; 2 on permanent histology; and 2 only on immunoperoxidase staining. In six, the sentinel node was the only positive node. There were seven true negatives and one false negative.
Conclusions:
Gross tumor replacement of lymph node architecture may obstruct and redirect lymphatic flow. Overall LS/SNB holds promise for oral cancer.
