Sentinel Lymph Node Evaluation in Squamous Cell Carcinoma of the Head and Neck

Abstract

OBJECTIVE: The aim of our study was to assess the feasibility of sentinel lymph node (SLN) radiolocalization in N₀ neck in squamous cell head and neck carcinoma and its predictive value for occult metastasis.

Study Design: Nineteen patients of an open prospective trial.

SETTING: After peritumoral injection of a 99m Tc labeled radiocolloid, the SLN was localized preoperatively by lymphoscintigraphy and intraoperatively through the intact skin by a hand-held gamma-probe. The histology of the SLN and the nodes of the elective neck dissection were compared.

RESULTS: Localization of the SLN by lymphoscintigraphy was possible in 18 of 19, and with the handheld gamma-probe in all 19 patients. Six SLN revealed occult metastatic disease. No skip metastasis were found in the 13 neck specimen with negative SLN.

CONCLUSION: SLN evaluation in N₀ neck in squamous cell carcinoma of the head and neck is accurately feasible and seems to adequately predict the presence of occult metastasis.

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