Department of Otolaryngology - Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.
Head Neck. 2014 Feb;36(2):241-6. doi: 10.1002/hed.23288. Epub 2013 Jun 1.
We report the outcome of sentinel node biopsy (SNB) for staging the neck in a consecutive cohort of 34 patients with T1/2 clinically N0 oral carcinoma.
SNB was performed along with resection of primary tumor. Neck dissection was reserved for failure of SNB or pathologically positive sentinel nodes (pN+).
Sentinel node identification was successful in 32 of 34 patients (94%); 2 patients with unsuccessful SNB underwent immediate neck dissection. Seven patients (21%) were pN+, 6 by SNB and 1 by elective neck dissection (END). Among 29 patients who were pN0 on SNB, nodal recurrence developed in 2 patients; both were surgically salvaged. Local failure developed in 1 patient. Two-year overall and disease-free survival was 87% and 80%, respectively.
Successful eradication of lymphatic metastasis noted in this study suggests that SNB may be a safe alternative to END for neck staging in patients with early oral carcinoma.
我们报告了 34 例 T1/2 期临床 N0 口腔癌患者连续队列中行前哨淋巴结活检（SNB）对颈部分期的结果。
SNB 与原发肿瘤切除术同时进行。如果 SNB 失败或前哨淋巴结（pN+）病理阳性，则保留颈部淋巴结清扫术。
34 例患者中有 32 例（94%）成功识别出前哨淋巴结；2 例 SNB 不成功的患者立即行颈部淋巴结清扫术。7 例（21%）患者 pN+，6 例通过 SNB，1 例通过选择性颈部淋巴结清扫术（END）。在 29 例 SNB 为 pN0 的患者中，2 例出现淋巴结复发，均经手术挽救。1 例出现局部复发。2 年总生存率和无病生存率分别为 87%和 80%。
本研究中观察到的淋巴结转移成功清除表明，SNB 可能是早期口腔癌颈部分期替代 END 的安全选择。
