The value of sentinel lymph node localization and biopsy in squamous cell carcinoma of the oral cavity

الملخص EN

Purpose : since the description of the technique of sentinel lymph node biopsy for malignant melanoma in the early 1990s, there has been a wide development of interest in this issue.

It is now being investigated for several malignant diseases as carcinoma of the vulva, cervix and penis.

In our country, head and neck cancer represents a larger group than most western reports (17 % vs.

5 %).

Oral cavity cancer represents one of the most common malignancies second to skin cancer in this region.

Accordingly our objective in this study is to investigate the feasibility and value of sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity.

Since neck dissections are being done for this group of patients, it would seem rational to devise this new technique to modulate patient treatment.

Material and Methods : Thirty patients with oral cavity carcinoma (T1-T4) N0 underwent sentinel node biopsy (SNB) at the National Cancer Institute Cairo University, prior to an elective neck dissection (END) for over two years.

Results : Identification of sentinel lymph nodes using isotope injection was successful in 28 of the 30 patients (93.4 %) and when using the patent blue dye the SLN was identified in 21 of the 30 cases examined (70 %).

Pathological examination of the 28 SLN identified with isotope injection proved negative for micrometastases in 25 cases (89.3 %) and positive in 3 cases (10.7 %).

Pathological examination of the other lymph nodes of the neck after neck dissection found 100 % agreement with pathology of SLN.

Pathological examination of SLN in the 21 cases identified using the dye found no microme-tastases.

Also examination of the lymph nodes after neck dissection found no micro metastases.

Conclusion : this preliminary but promising experience with SLN identification in squamous cell carcinoma of the oral cavity may offer the potential to treat only node positive patients with this approach while avoiding the morbidity of treatment of node negative patients.