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>Journals >Cirugía y Cirujanos >Year 2006, Issue 3

Gallegos-Hernández JF
Lymphatic mapping and sentinel node biopsy in squamous cell carcinoma of head and neck mucosa
Cir Cir 2006; 74 (3)

Language: Español
References: 23
Page: 167-173
PDF: 79.48 Kb.

[Full text - PDF]


Background: Lymphatic mapping with sentinel node biopsy (LMSNB) is a staging alternative in melanoma and breast cancer. In oral cavity cancer (OCC) without palpable nodes, the recommended surgical treatment is elective-selective neck dissection; nevertheless, 70% will not show metastasis. LMSNB might be a staging alternative. Our objective was to determine if this technique allows the identification of sentinel node.
Methods: Characteristics were T1–2, N0, OCC patients ›4 mm of tumor thickness. We injected 3 mCi of rhenium and 2 ml of blue dye around the tumor and performed a lymphogammagraphy. Sentinel node (SN) was identified by color and radioactivity, and all patients were submitted to suprahyoid dissection. Index of success, false negative, and negative predictive values were calculated.
Results: Of 41 patients, there were 20 females and 21 males. Lymphogammagraphy showed a SN in each patient. SN was identified in all patients during surgery: in 10 patients the SN was “hot”(24%) and in 31 (75%) “hot and blue”; 13/41 (31.7%) showed metastasis, 4 had negative SN (false negative); in 3/13 metastatic SN. Diagnosis was made by definite analysis. All patients with false negative had tumors ›2 cm.
Conclusions: LMSNB in oral cavity cancer has a high index of success and radical neck dissection could be avoided in 80% of patients with T1-2 tumors.

Key words: Sentinel node, oral cavity, tongue cancer.


  1. 1.Shah JP, Lydiatt WM. Buccal mucosa, alveolus retromolar trigone, floor of the mouth, hard palate and tongue tumors. In: Thawlew SE, Panje WR, Batsakis JG, Lindberg RD, eds. Comprehensive Management of Head and Neck Tumors. Philadelphia: WB Saunders;1999. pp. 686-694.

  2. 2.Boyle JO, Strong EW. Oral cavity cancer. In: Shah JP, ed. Cancer of the Head and Neck. Hamilton, BC: Decker;2001. pp. 100-126.

  3. 3.Gallegos HJF, Hernández HDM, Arias CH, et al. Elective neck dissection in oral tongue cancer. Rev Oncol 2004;6:41-44.

  4. 4.Andersen PE, Saffold S. Management of cervical metastasis. In: Shah JP, ed. Cancer of the Head and Neck. Hamilton, BC: Decker; 2001. pp. 274-287.

  5. 5.Vandenbrouck C, Sancho Garnier H, Chassagne D, et al. Elective versus therapeutic radical neck dissection in epidermoid carcinoma of the oral cavity. Cancer 1980;46:386-390.

  6. 6.Gallegos HJF, Martínez GH, Flores DR. The radical neck dissection in upper aero-digestive tract cancer. Indications, extension and radicality. Cir Ciruj 2002;70:369-376.

  7. 7.Gallegos HJF, Gutiérrez CF, Barroso BS, y cols. Identificación del ganglio centinela con azul patente V en pacientes con melanoma cutáneo. Gac Med Mex 1998; 134:285-288.

  8. 8.Gallegos HJF, Nieweg OE, Tanis P y cols. La biopsia del ganglio centinela en melanoma no es aún el tratamiento estándar. Gac Med Mex 2003;139:205-208.

  9. 9.Gallegos HJF, Chávez GMA. Utilidad del mapeo linfático con inyección subareolar de colorante azul patente, en la etapificación del cáncer de mama. Rev Invest Clin 2003;55:407-411.

  10. 10.Gallegos HJF. Linfadenectomía selectiva del ganglio centinela en pacientes con cáncer de mama. Una alternativa a la disección radical de axila. Acta Med 2003;1:127-131.

  11. 11.Gould EA, Winship T, Philbin PH, et al. Observations on a “sentinel node” in cancer of the parotid. Cancer 1960;13:77-78.

  12. 12.Cabañas RM. An approach for the treatment of penile carcinoma. Cancer 1977;39:456-466.

  13. 13.Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392-399.

  14. 14.van Iterson V, Leidenius M, Krogerus L, von Smiten K. Predictive factors for the status non-sentinel nodes in breast cancer patients with tumor positive sentinel nodes. Breast Cancer Res Treat 2003;82: 39-45.

  15. 15.Fleming FJ, Kavanagh D, Crotty TB, et al. Factors affecting metastases to non-sentinel nodes in breast cancer. J Clin Pathol 2004;57: 73-76.

  16. 16.Nieweg OE, Jansen L, Valdés-Olmos RA, et al. Lymphatic mapping and sentinel lymph node biopsy in breast cancer. Eur J Nucl Med 1999;26(suppl):S11-16.

  17. 17.Mamelle G. Selective neck dissection and sentinel node biopsy in head and neck squamous cell carcinomas. Rec Results Cancer Res 2000;157:193-200.

  18. 18.Ross G, Shoaib T, Soutar DS, et al. The use of sentinel node biopsy to upstage the clinically N0 neck in head and neck cancer. Arch Otolaryngol Head Neck Surg 2002;128:1287-1291.

  19. 19.Werner JA, Düne AA, Myers JN. Functional anatomy of the lymphatic drainage system of the upper aero-digestive tract and its role in metastasis of squamous cell carcinoma. Head Neck 2003;25:322-332.

  20. 20.Koch WM, Choti MA, Civelek AC, et al. Gamma probe-directed biopsy of the sentinel node in oral squamous cell carcinoma. Arch Otolaryngol Head Neck Surg 1998;124:455-459.

  21. 21.Shoaib T, Soutar DS, Prosser JE, et al. A suggested method for sentinel node biopsy in squamous cell carcinoma of the head and neck. Head Neck 1999;21:728-733.

  22. 22.Ross GL, Shoaib T, Soutar DS, et al. The First International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer and adoption of a multicenter trial protocol. Ann Surg Oncol 2002;9:406-410.

  23. 23.Stoeckli SJ, Pfaltz M, Ross GL, et al. The Second International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer. Ann Surg Oncol 2005;12:919-924.

>Journals >Cirugía y Cirujanos >Year 2006, Issue 3

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