Frerich Bernhard, Förster Marcus, Schiefke Franziska, Wittekind Christian, Hemprich Alexander, Sabri Osama
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University of Leipzig, Leipzig, Germany.
J Surg Oncol. 2007 Feb 1;95(2):97-105. doi: 10.1002/jso.20664.
Despite the availability of initial data on sentinel lymph node biopsy (SLNB) in OSCC, its value in clinical practice remains unclear. The aim of this study is to evaluate the feasibility and potential of SLNB as a reliable staging procedure in early stage SCC of the lips and the oral mucosa.
From 2001 to 2004, 40 patients with early stage SCC of the lips and oral cavity were enrolled. The main inclusion criteria were: cN0 category by MRI and ultrasound, tumor category T1-T2, for certain sites also T3. Patients with positive SLN underwent MRND and/or radiation. Patients with negative SLN were monitored monthly.
In eight patients, the SLN were positive. Two patients with negative SLN subsequently developed nodal disease (5% false negatives). Twenty-one patients have a follow-up longer than 24 months. Five patients died (one from nodal disease, one from local recurrence, and three from unrelated causes). One patient developed a second primary tumor, the remaining patients are free of disease.
SLNB may contribute to more targeted lymph node dissection strategies. Further studies will have to ensure the safety of this procedure in comparison to selective neck dissection.
尽管已有关于口腔鳞状细胞癌（OSCC）前哨淋巴结活检（SLNB）的初步数据，但其在临床实践中的价值仍不明确。本研究旨在评估SLNB作为唇部和口腔黏膜早期鳞状细胞癌（SCC）可靠分期方法的可行性和潜力。
2001年至2004年，纳入40例唇部和口腔早期SCC患者。主要纳入标准为：MRI和超声检查为cN0类别，肿瘤类别为T1 - T2，某些部位也可为T3。前哨淋巴结阳性的患者接受了颈淋巴清扫术（MRND）和/或放疗。前哨淋巴结阴性的患者每月进行监测。
8例患者前哨淋巴结阳性。2例前哨淋巴结阴性的患者随后出现淋巴结疾病（假阴性率5%）。21例患者随访时间超过24个月。5例患者死亡（1例死于淋巴结疾病，1例死于局部复发，3例死于无关原因）。1例患者发生了第二原发性肿瘤，其余患者无疾病。
前哨淋巴结活检可能有助于制定更具针对性的淋巴结清扫策略。与选择性颈清扫术相比，进一步的研究必须确保该手术的安全性。
