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10.1245/ASO.2006.09.023
Annals of Surgical Oncology 13:1130-1135 (2006)
© 2006 Society of Surgical Oncology
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Original Article

Radiolocalized Sentinel Lymph Node Biopsy in Squamous Cell Carcinoma of the Oral Cavity and Analysis of Various Parameters

Ching-Yu Yen, DDS1, Sheng-Yang Lee, DDS2, Jih-Fang Hsieh, MD3, Dun-Zheng Wang, DDS2, Gin-Nan Lin, MD4, Chih-Mong Tsai, DDS2 and Shyun-Yui Liu, DDS1,2

1 Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, 901 Chung Hwa Road, Yung Kang City, Tainan 710, Taiwan
2 School of Dentistry and Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
3 Department of Radiology, Division of Nuclear Medicine, Chi Mei Medical Center, Tainan, Taiwan
4 Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan

Correspondence: Address correspondence and reprint requests to: Shyun-Yui Liu, MD; E-mail: ycysmc{at}yahoo.com.tw.

Background: Sentinel lymph node (SLN) biopsy seems to be a method that solves the problem of neck management with oral squamous cell carcinoma. Using blue dye methods for detection of neck SLNs from the surface of the operative field seems difficult; therefore, we used radiolocalization alone to detect and extract sentinel nodes. Aside from the various histological and clinical parameters examined in this procedure, we also determined whether they had any clinical significance in relation to the detection of SLNs during the operation.

Methods: Enrolled subjects had preoperative clinical N0 stage squamous cell carcinoma of the oral cavity and had received an unfiltered 99mTc sulfur colloid peritumoral injection. Localization of the SLNs was performed by using lymphoscintigraphy and a handheld gamma probe.

Results: In total, 28 oral squamous cell carcinoma patients were included in this prospective study. Sixty-four SLNs in 27 patients were identified by this method. The identification rate was 96.4%. No false-negative predictions of SLN were noted among any of the patients studied. The numbers of the SLNs found during the operation were larger in patients with positive findings than those with negative findings (P < .05 by the Mann-Whitney U-test).

Conclusions: SLN radiolocalization provided an acceptable identification rate. The cases of positive findings for metastasis seemed to statistically have more SLNs than did those with negative findings, but more evidence is needed to prove this point. Therefore, SLN biopsies for extracting all possible high-risk nodes may be conducive for oral squamous cell carcinoma surgery.

Key Words: Sentinel lymph node biopsy • Radiolocalized • Oral cavity • Squamous cell carcinoma






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