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Technique for reliable sentinel node biopsy in squamous cell carcinomas of the floor of mouth
Author(s) -
Stoeckli Sandro J.,
Huebner Thomas,
Huber Gerhard F.,
Broglie Martina A.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24440
Subject(s) - medicine , sentinel node , sentinel lymph node , gamma probe , biopsy , lymph , neck dissection , basal cell , radiology , floor of mouth , head and neck , lymph node , dissection (medical) , nuclear medicine , carcinoma , surgery , pathology , cancer , tongue , breast cancer
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