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[Sentinel node mapping in head and neck squamous cell carcinoma].

Alessandro Relic¹, C Aletsee, D Brors

¹Bayerische Julius-Maximilians-Universität, Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, 97080 Würzburg. a.relic@mail.uni-wuerzburg.de

Laryngo- Rhino- Otologie

|December 30, 2006

Summary

Sentinel lymph node (SLN) biopsy shows promise for staging head and neck squamous cell carcinoma (SCC). This method may help determine if an elective neck dissection is necessary, potentially reducing patient morbidity.

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Area of Science:

Oncology
Surgical Oncology
Head and Neck Cancer Research

Background:

Conventional staging for head and neck squamous cell carcinoma (SCC) often fails to detect micro-metastases, necessitating elective neck dissection (ND).
Sentinel lymph node (SLN) identification is a reliable staging method in melanoma and breast cancer surgery.
The study investigates the applicability of SLN biopsy for SCC of the head and neck.

Purpose of the Study:

To evaluate the effectiveness of sentinel lymph node (SLN) biopsy in staging head and neck squamous cell carcinoma (SCC).
To determine if SLN biopsy can accurately predict lymphatic metastasis and guide the decision for elective neck dissection (ND).

Main Methods:

Radioactive micro-albumin particles were injected around the tumor in 38 patients without confirmed metastases.

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Sentinel lymph nodes (SLNs) were detected and dissected after primary tumor excision, followed by completion neck dissection (ND).

Histopathological examination of SLNs and ND specimens assessed lymphatic spread.

Main Results:

Sentinel lymph node (SLN) detection failed in 5.1% of cases; neck dissection (ND) was completed in 32 patients.
SLNs were metastatic in 28.1% of patients; 68.8% had a confirmed N(0) stage based on both SLN and ND.
The negative predictive value for metastasis was 96%, though one metastasis was obscured by anatomical proximity to the primary tumor.

Conclusions:

Sentinel lymph node (SLN) biopsy offers higher predictive value for neck metastases compared to traditional staging methods in head and neck squamous cell carcinoma (SCC).
The decision to forgo elective neck dissection (ND) based on a tumor-free SLN requires further consideration, particularly regarding the reduction of postoperative morbidity.