Technique for reliable sentinel node biopsy in squamous cell carcinomas of the floor of mouth

Publication

Technique for reliable sentinel node biopsy in squamous cell carcinomas of the floor of mouth

Journal Paper/Review - Mar 29, 2016

Stöckli Sandro, Huebner Thomas, Huber Gerhard F, Broglie Däppen Martina

Citation

Stöckli S, Huebner T, Huber G, Broglie Däppen M. Technique for reliable sentinel node biopsy in squamous cell carcinomas of the floor of mouth. Head & neck 2016; 38:1367-72.

Type

Journal Paper/Review (English)

Journal

Head & neck 2016; 38

Publication Date

Mar 29, 2016

Issn Electronic

1097-0347

Pages

1367-72

Brief description/objective

BACKGROUND
Applicability of sentinel node biopsy (SNB) for tumors of the floor of mouth (FOM) is controversial.

METHODS
Prospective evaluation of the accuracy of gamma-probe-guided superselective neck dissection of the preglandular triangle of level I for SNB in FOM squamous cell carcinoma (SCC) after preoperative lymphoscintigraphy and single photon emission CT (SPECT)/CT.

RESULTS
In total, 22 sentinel lymph nodes were harvested in level I. Eight of 22 (36%) were seen on lymphoscintigraphy and 11 (50%) on SPECT/CT. Eleven sentinel lymph nodes (50%) were only detected intraoperatively. In unilateral tumors, 20% were contralateral, and, in midline tumors, 93% showed bilateral level I sentinel lymph nodes. The false-negative rate was 8.3%, the negative predictive value was 96.4%, and the false-omission rate was 3.6%. The ultimate neck control rate, including salvage treatment, was 100%.

CONCLUSION
SNB in FOM can be reliably performed using the presented surgical technique. Level I exploration, bilaterally in midline tumors, is mandatory irrespective of the visualization of sentinel lymph nodes in other levels. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1367-1372, 2016.