Usefulness of sentinel node navigation surgery in the management of early tongue cancer.

Abstract

OBJECTIVE:

To determine the validity of sentinel node navigation surgery (SNNS) in early stage tongue cancer, the occurrence rate of postoperative cervical metastasis (POCM) after lead plate technique (LPT) introduction and survival rates in patients who underwent SNNS were analyzed.

METHODS:

SNNS was performed in 29 patients (stage I: 14, stage II: 15) from 2000 to 2007. Tc-labeled phytate was prepared as a radiotracer a day before SNNS. The sentinel node (SN) was then examined pathologically during surgery. For cases where metastasis in SN was positive, neck dissection was performed. Occurrence of POCM after LPT introduction was compared with that before LPT introduction. 'Wait and see' policy was performed in 52 patients (stage I: 27, stage II: 25) from 1987 to 1999 as a historical control. The observation period of SNNS cases and 'wait and see' policy cases ranged from 10 months to 165 months (median: 91 months) and from 7 months to 268 months (median: 87 months), respectively.

RESULTS:

Six of the 29 SNNS cases (21%) were proven metastatic SNs. Before LPT introduction, POCM occurred in 2 of the 15 cases, while we had no occurrences after LPT introduction. The 5-year overall survival rate of the 29 patients who underwent SNNS and the 52 patients with 'wait and see' policy were 96% and 84%, respectively, and there was statistical significance in the two groups (p<0.05).

CONCLUSIONS:

As the survival rate of the patients with the SNNS tended to be better than that with the 'wait and see' policy in our cases, SNNS could avoid unnecessary neck dissection. SNNS provides useful information regarding decision-making for neck dissection in early stage tongue cancer.

• Authors: Takashi Matsuzuka, Masahiro Suzuki, Satoshi Saijo, Takamichi Matsui, Yukio Nomoto, Masakazu Ikeda, Yasuhiro Tada, Mika Nomoto, Koichi Omori
• Journal: Auris, nasus, larynx (Auris Nasus Larynx) Vol. 41 Issue 5 Pg. 475-8 (Oct 2014) ISSN: 1879-1476 [Electronic] Netherlands
• PMID: 24913730 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Squamous Cell (pathology, surgery)
• Cohort Studies
• Female
• Glossectomy (methods)
• Head and Neck Neoplasms (pathology, surgery)
• Humans
• Lymph Nodes (pathology)
• Lymphatic Metastasis
• Male
• Middle Aged
• Neck
• Neck Dissection
• Neoplasm Staging
• Retrospective Studies
• Sentinel Lymph Node Biopsy
• Squamous Cell Carcinoma of Head and Neck
• Tongue Neoplasms (pathology, surgery)
• Young Adult