Biopsie sentinelové uzliny u pacientů s karcinomem ústní dutiny a orofaryngu

Sentinel Lymph Node Biopsy in Oral and Oropharyngeal Carcinomas

Background.
The aim of our study was to assess feasibility and accuracy of sentinel lymph node biopsy in patients with head and neck squamous cell carcinoma with clinically N0 neck. 

Methods and Results.
The sentinel lymph node was localised preoperatively by lymphoscintigraphy and intraoperatively by hand-held gamma probe after peritumoral injection of a Tc99m-labeled colloidal human serum albumin. The histology of the sentinel lymph node was compared with the histology of the nodes of the elective neck dissection performed in all patients. 27 patients with oral and oropharyngeal carcinomas accessible to injection in local anaesthesia were enrolled into a prospective trial between July 1993 and December 2005. The sentinel lymph node was localised by preoperative lymphoscintigraphy in 26 of 27 patients. Sentinel lymph node was identified perioperatively by hand-held gamma probe in all 28 necks of 27 patients. Occult metastases were found in 4 sentinel lymph nodes in 4 cases. In one case (3.6 %) the result of sentinel lymph node biopsy was false negative. The sentinel lymph node biopsy correctly predicted the positivity and negativity of the neck in 27 of 28 cases (96.4 %). 

Conclusions.
Sentinel lymph node biopsy in patients with oral and oropharyngeal carcinomas is feasible and seems to accurately predict the status of the regional lymph nodes. 

Key words:
elective neck dissection, hand-held gamma probe, head and neck cancer, lymphoscintigraphy, sentinel lymph node.