A Novel Sentinel Lymph Node Approach in Oral Squamous Cell Carcinoma

Area of Science:

• Oncology
• Surgical Oncology
• Nuclear Medicine

Background:

• Occult metastases are frequent in oral squamous cell carcinoma (OSCC).
• Current management includes elective neck dissection, radiotherapy, or watchful waiting.
• Sentinel lymph node biopsy (SLNB) offers a new approach for treatment planning.

Purpose of the Study:

• To develop a reliable and clinically applicable protocol for SLNB in oral cancer staging.
• To refine elective neck dissection strategies for oral cancer patients.

Main Methods:

• A novel SLNB protocol was developed and tested.
• Pre-surgical injection of radioactive technetium 99Tcm (tilmanocept/Lymphoseek®) at the tumor site.
• Preoperative SPECT/CT imaging, intraoperative indocyanine green (ICG) injection with near-infrared visualization, and gamma probe detection.

Main Results:

• A combination of techniques resulted in a reliable and adaptable work concept.
• The protocol demonstrated reproducible and reliable sentinel node detection.
• Enabled subsequent flow cytometry analysis of resected lymph nodes.

Conclusions:

• A novel protocol for sentinel node identification in head and neck cancer was presented.
• This protocol enhances the accuracy of staging for oral cancer.
• Facilitates further analysis of lymph nodes for improved patient management.