• 10/3/2003
  • Florida
  • Ed Susman
  • American Academy of Otolaryngology-Head and Neck Surgery Foundation

Identifying and locating the sentinel node in head–and-neck cancer surgery is feasible, and the results of careful dissection of the nodes appears to correlate with full neck dissection, researchers said here September 21st at the Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation.

In describing findings from a recent study, lead author Peter Zbaeren, MD, department of otorhinolaryngology–Head and Neck Surgery, University of Bern–Inselspital, Switzerland, said, “Accurate localisation of the sentinel nodes was possible in all cases by using lymphoscintigraphy and by use of a gamma probe.”

Dr. Zbaeren and colleagues found 82 sentinel nodes in 36 patients — about 2.2 nodes per patient. Using a radionuclide-labeled colloid, preoperative lymphoscintigraphy and intraoperative sentinel lymph-node identification by a gamma probe, doctors located the sentinel lymph node, excised the node or nodes and performed frozen section analysis.

The study sought to assess the accuracy of sentinel lymph node identification in patients with a Stage NO neck in squamous-cell carcinoma of the oral cavity and oropharynx.

Dr. Zbaeren said the pathology analysis located one occult cancer in a sentinel lymph node. To correlate these findings, the surgeons carried out a complete neck dissection in the patients, removing an average of 36 nodes from each patient. In the 1,295 nodes analysed, just one positive node was found.

Dr. Zbaeren said the sensitivity of sentinel lymph-node biopsy in the series was 93%, and the negative predictive value was 94%. Complete dissection resulted in 100% sensitivity and negative predictive value, he added.

The researchers said the results suggested that the sentinel-node procedure could be used to reduce the need for more extensive biopsy procedures. “The study shows that sentinel lymph-node biopsy in head and neck surgery is feasible and accurate,” Dr. Zbaeren concluded.

[Study title: Value Of Sentinel Lymph Node Biopsy For Oral And Oropharynx Carcinoma.]