Sagheb Keyvan, Sagheb Kawe, Rahimi-Nedjat Roman, Taylor Kathy, Al-Nawas Bilal, Walter Christian
Department of Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Centre, Johannes Gutenberg-University of Mainz, Mainz 55131, Germany.
Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg-University of Mainz, Mainz 55131, Germany.
Oncol Lett. 2016 Jan;11(1):600-604. doi: 10.3892/ol.2015.3933. Epub 2015 Nov 17.
Commonly used staging procedures often cannot predict the absence of cervical metastases (CM) in squamous cell carcinomas (SCCs) of the oral cavity. Due to the high incidence of occult CM in numerous N0 cases in the clinic, an elective neck dissection (ND) is performed. The sentinel lymph node biopsy (SNB) is a common concept in the modern surgical therapy of malignancies. The present study evaluates the applicability of this concept for T1/T2-SCC of the tongue. In a prospective clinical study, 10 consecutive patients with T1/T2-SCC of the tongue and cN0 necks, were enrolled. Following sentinel lymph node (SLN) scintigraphy, all patients underwent SNB with a γ-probe and a subsequent ND. SNB specimens were compared with histopathological assessments of surgical specimens from the ND. A total of 5 female and 5 male patients (mean age, 52 years; women, 62 years; men, 42 years), with a median follow-up time of 33.5 months (range, 10-40 months), were treated. All patients presented with detectable SLNs. In 7 cases, the SLN(s) and the residual ND were negative for CM. In 3 cases, the SLN(s) were positive without further CM in the other neck nodes. Furthermore, 1 patient showed additional CMs after 10 months in the contralateral neck and lung metastasis after 18 months, but none at the time of the initial treatment. The concept of an SNB appears to be applicable to the management of the cN0 neck in small SCC of the tongue. The role of SNB in the management of SCC requires further investigation by prospective trials with larger patient numbers.
常用的分期程序往往无法预测口腔鳞状细胞癌（SCC）是否存在颈部转移（CM）。由于临床上众多N0病例中隐匿性CM的发生率很高，因此需要进行选择性颈清扫术（ND）。前哨淋巴结活检（SNB）是现代恶性肿瘤外科治疗中的一个常见概念。本研究评估了这一概念在舌部T1/T2-SCC治疗中的适用性。在一项前瞻性临床研究中，连续纳入了10例舌部T1/T2-SCC且颈部cN0的患者。在前哨淋巴结（SLN）闪烁扫描后，所有患者均接受了γ探头引导下的SNB及随后的ND。将SNB标本与ND手术标本的组织病理学评估结果进行比较。共治疗了5例女性和5例男性患者（平均年龄52岁；女性62岁，男性42岁），中位随访时间为33.5个月（范围10 - 40个月）。所有患者均检测到SLN。7例患者的SLN及剩余的ND均未发现CM。3例患者的SLN呈阳性，但其他颈部淋巴结未发现进一步的CM。此外，1例患者在10个月后对侧颈部出现额外的CM，18个月后出现肺转移，但初始治疗时均未发现。SNB概念似乎适用于舌部小SCC的cN0颈部管理。SNB在SCC管理中的作用需要通过更大样本量的前瞻性试验进一步研究。
