Sentinel node biopsy in oral cavity cancer: Correlation with PET scan and immunohistochemistry

Authors

  • Francisco J. Civantos MD,

    Corresponding author
    1. Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136
    • Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136
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  • Carmen Gomez MD,

    1. Department of Pathology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, Miami, Florida 33136
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  • Carlos Duque MD,

    1. Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136
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  • Felipe Pedroso,

    1. Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136
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  • William Jarrard Goodwin MD,

    1. Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136
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  • Donald T. Weed MD,

    1. Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136
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  • David Arnold MD,

    1. Department of Otolaryngology, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, 1475 NW 12 Avenue, Suite 4027, Miami, Florida 33136
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  • Fred Moffat MD

    1. Department of Surgery, University of Miami Hospital and Clinics/Sylvester Comprehensive Cancer Center, Miami, Florida 33136
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Abstract

Background.

Lymphoscintigraphy and sentinel node biopsy (LS/SNB) is a minimally invasive technique that samples first-echelon lymph nodes to predict the need for more extensive neck dissection.

Methods.

We evaluated this technique in 18 oral cavity cancers, stages T1–T3, N0. Patients underwent CT and positron emission tomography (PET) of the neck, followed by LS/SNB, frozen section, immediate selective neck dissection, definitive histology, and immunoperoxidase staining for cytokeratin. Histopathology of the sentinel node was correlated with that of the neck specimen.

Results.

There were 10 true positives: 6 identified on frozen section; 2 on permanent histology; and 2 only on immunoperoxidase staining. In six, the sentinel node was the only positive node. There were seven true negatives and one false negative.

Conclusions.

Gross tumor replacement of lymph node architecture may obstruct and redirect lymphatic flow. Overall LS/SNB holds promise for oral cancer. © 2002 Wiley Periodicals, Inc. Head Neck 25: 000–000, 2003

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