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Updated: Aug 23, 2026
Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
The sentinel node concept in head and neck cancer: solution for the controversies in the N0 neck?
Jochen A Werner1, Anja A Dünne, Anette Ramaswamy
1Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Germany. wernerj@med.uni-marburg.de
Background:
The majority of patients with head and neck squamous cell carcinoma (HNSCC) who have a clinical N0 neck undergo neck dissection (ND) even though no lymph node metastases may be detected. With this background, our investigation critically analyzes the value of sentinel lymphadenectomy.
Methods:
Ninety patients with HNSCC, all staged with an N0 neck, underwent intraoperative 99mTc-radiolabeled detection of up to three hot nodes (SN1-3) during elective ND and primary site resection.
Results:
Sentinel lymphadenectomy (SN1-3) detected occult metastatic spread in 20 (22%) of 90 patients, whereas failure occurred in three of 90 patients. Metastatic spread was directed to level II in the majority (66.7%) of cases. If only the SN1 had been examined, the procedure would have failed in nine (39%) of 23 patients.
Conclusion:
Sentinel lymphadenectomy correctly identified the stage of metastatic disease in 97% of patients in cases in which up to three sentinel nodes were identified. If only the lymph node with the highest tracer activity had been excised, 39% of cancer-positive necks would have been missed. Selective ND identified metastatic disease in the additional 3% of patients.