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Role of sentinel node biopsy in the management and staging of the N0 neck

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Abstract

Sentinel node biopsy is being increasingly used as a staging tool for mucosal head and neck cancer. This review of the literature summarizes the results of research into the procedure when it has been performed in three main contexts: as part of an ipsilateral neck dissection, as a stand-alone procedure to stage the neck for positive or negative disease, and as a means of investigating the non-involved or contralateral neck in tumors close to or crossing the midline. The role of the procedure is discussed and the difficulties encountered are expanded, with a particular emphasis on pitfalls of the technique, caveats, and its potential role for the future.

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References

  1. CR Leemans RM Tiwari JJP Nauta I van der Waal GB Snow (1993) ArticleTitleRegional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma Cancer 71 452–6 Occurrence Handle8422638

    PubMed  Google Scholar 

  2. M Noguchi Y Kido H Kubota H Kinjo G Kohama (1999) ArticleTitlePrognostic factors and relative risk for survival in N1-3 oral squamous cell carcinoma: a multivariate analysis using Cox’s hazard model Br J Oral Maxillofac Surg 37 433–7 Occurrence Handle10.1054/bjom.1999.0146 Occurrence Handle10687900

    Article  PubMed  Google Scholar 

  3. G Mamelle J Pampurik B Luboinski R Lancar A Lusinchi J Bosq (1994) ArticleTitleLymph node prognostic factors in head and neck squamous cell carcinomas Am J Surg 168 494–8 Occurrence Handle7977983

    PubMed  Google Scholar 

  4. LH Sobin Ch Wittelind (Eds) (2002) International Union Against Cancer: TNM classification of malignant tumours EditionNumber6th ed. Wiley New York, NY

    Google Scholar 

  5. MW van den Brekel JA Castelijns HV Stel RP Golding CJ Meyer GB Snow (1993) ArticleTitleModern imaging techniques and ultrasound-guided aspiration cytology for the assessment of neck node metastases: a prospective comparative study Eur Arch Otorhinolaryngol 250 11–7 Occurrence Handle8466744

    PubMed  Google Scholar 

  6. SJ Stoeckli H Steinert M Pfaltz S Schmid (2002) ArticleTitleIs there a role for positron emission tomography with 18F-fluorodeoxyglucose in the initial staging of nodal negative oral and oropharyngeal squamous cell carcinoma Head Neck 24 345–9 Occurrence Handle10.1002/hed.10057 Occurrence Handle11933176

    Article  PubMed  Google Scholar 

  7. FJ Civantos C Gomez C Duque F Pedroso WJ Goodwin DT Weed D Arnold F Moffat (2003) ArticleTitleSentinel node biopsy in oral cavity cancer: correlation with PET scan and immunocytochemistry Head Neck 25 1–9 Occurrence Handle10.1002/hed.10213 Occurrence Handle12478537

    Article  PubMed  Google Scholar 

  8. JA Woolgar ED Vaughan J Scott JS Brown (1994) ArticleTitlePathological findings in clinically false-negative and false-positive neck dissections for oral carcinoma Ann R Coll Surg Engl 76 237–44 Occurrence Handle8074384

    PubMed  Google Scholar 

  9. JC Watkinson D Johnston N Jones M Coady D Laws S Allen (1990) ArticleTitleThe reliability of palpation in the assessment of tumors Clin Otolaryngol 15 405–9 Occurrence Handle2282701

    PubMed  Google Scholar 

  10. CJ O’Brien SJ Traynor E McNeil JD McMahon JM Chaplin (2000) ArticleTitleThe use of clinical criteria alone in the management of the clinically negative neck among patients with squamous cell carcinoma of the oral cavity and oropharynx Arch Otolaryngol Head Neck Surg 126 360–5 Occurrence Handle10722009

    PubMed  Google Scholar 

  11. Y Anzai JA Brunberg RB Lufkin (1997) ArticleTitleImaging of nodal metastases in the head and neck J Magn Reson Imaging 7 774–83 Occurrence Handle9307901

    PubMed  Google Scholar 

  12. JC Watkinson CR Lazarus C Todd MN Maisey SE Clarke (1991) ArticleTitleMetastatic squamous carcinoma in the neck: an anatomical and physiological study using CT and SPECT 99Tcm (V) DMSA Br J Radiol 64 909–14 Occurrence Handle1659474

    PubMed  Google Scholar 

  13. MW van den Brekel JA Castelijns (1999) ArticleTitleRadiologic evaluation of neck metastases: the otolaryngologist’s perspective Semin Ultrasound CT MR 20 162–74 Occurrence Handle10.1016/S0887-2171(99)90017-3 Occurrence Handle10378250

    Article  PubMed  Google Scholar 

  14. MW van den Brekel (2000) ArticleTitleLymph node metastases: CT and MRI Eur J Radiol 33 230–8 Occurrence Handle10.1016/S0720-048X(99)00145-X Occurrence Handle10699739

    Article  PubMed  Google Scholar 

  15. MW van den Brekel JA Castelijns (2000) ArticleTitleImaging of lymph nodes in the neck Semin Roentgenol 35 42–53 Occurrence Handle10670052

    PubMed  Google Scholar 

  16. MW van den Brekel JA Castelijns LC Reitsma CR Leemans I van GB Snow (1999) ArticleTitleOutcome of observing the N0 neck using ultrasonographic-guided cytology for follow-up Arch Otolaryngol Head Neck Surg 125 153–6 Occurrence Handle10037281

    PubMed  Google Scholar 

  17. RM Merritt MF Williams TH James ES Porubsky (1997) ArticleTitleDetection of cervical metastasis. A meta-analysis comparing computed tomography with physical examination Arch Otolaryngol Head Neck Surg 123 149–52 Occurrence Handle9046281

    PubMed  Google Scholar 

  18. JD Wagner D Schauwecker D Davidson JJ Coleman SuffixIII S Saxman G Hutchins (1999) ArticleTitleProspective study of fluorodeoxyglucose-positron emission tomography imaging of lymph node basins in melanoma patients undergoing sentinel node biopsy J Clin Oncol 17 1508–15 Occurrence Handle10334538

    PubMed  Google Scholar 

  19. G Ross T Shoaib DS Soutar IG Camilleri HW Gray RG Bessent AG Robertson DG MacDonald (2002) ArticleTitleThe use of sentinel node biopsy to upstage the clinically N0 neck in head and neck cancer Arch Otolaryngol Head Neck Surg 128 1287–91 Occurrence Handle12431172

    PubMed  Google Scholar 

  20. GL Ross DS Soutar DG MacDonald T Shoaib IG Camilleri AG Robertson (2004) ArticleTitleImproved staging of cervical metastasis in clinically negative patients with head and neck squamous cell carcinoma Ann Surg Oncol 11 213–8 Occurrence Handle10.1245/ASO.2004.03.057 Occurrence Handle14761927

    Article  PubMed  Google Scholar 

  21. GL Ross DS Soutar D Gordon MacDonald T Shoaib I Camilleri AG Roberton JA Sorensen J Thomsen P Grupe J Alvarez L Barbier J Santamaria T Poli O Massarelli E Sesenna AF Kovacs F Grunwald L Barzan S Sulfaro F Alberti (2004) ArticleTitleSentinel node biopsy in head and neck cancer. Preliminary results of a multicenter trial Ann Surg Oncol 11 690–6 Occurrence Handle10.1245/ASO.2004.09.001 Occurrence Handle15197011

    Article  PubMed  Google Scholar 

  22. SJ Stoeckli M Pfaltz H Steinert S Schmid (2002) ArticleTitleHistopathological features of occult metastasis detected by sentinel lymph node biopsy in oral and oropharyngeal squamous cell carcinoma Laryngoscope 112 111–5 Occurrence Handle10.1097/00005537-200201000-00019 Occurrence Handle11802047

    Article  PubMed  Google Scholar 

  23. JA Werner AA Dunne A Ramaswamy BJ Folz BM Lippert R Moll T Behr (2002) ArticleTitleSentinel node detection in N0 cancer of the pharynx and larynx Br J Cancer 87 711–5 Occurrence Handle10.1038/sj.bjc.6600445 Occurrence Handle12232751

    Article  PubMed  Google Scholar 

  24. P Ambrosch U Brinck (1996) ArticleTitleDetection of nodal micrometastasis in head and neck cancer by serial sectioning and immunostaining Oncology Huntingt 10 1221–6 Occurrence Handle8869961

    PubMed  Google Scholar 

  25. JA Woolgar (1999) ArticleTitleMicrometastasis in oral/oropharyngeal squamous cell carcinoma: incidence, histopathological features and clinical implications Br J Oral Maxillofac Surg 37 181–6 Occurrence Handle10.1054/bjom.1999.0037 Occurrence Handle10454024

    Article  PubMed  Google Scholar 

  26. A Ferlito KO Devaney A Rinaldo SL Devaney A Carbone (1999) ArticleTitleMicrometastases: have they an impact on prognosis? Ann Otol Rhinol Laryngol 108 1185–9 Occurrence Handle10605927

    PubMed  Google Scholar 

  27. MW van den Brekel HV Stel P van der Valk I van der Waal CJ Meyer GB Snow (1992) ArticleTitleMicrometastases from squamous cell carcinoma in neck dissection specimens Eur Arch Otorhinolaryngol 249 349–53 Occurrence Handle1384570

    PubMed  Google Scholar 

  28. JA Woolgar JC Beirne ED Vaughan HG Lewis-Jones J Scott JS Brown (1995) ArticleTitleCorrelation of histopathologic findings with clinical and radiologic assessments of cervical lymph-node metastases in oral cancer Int J Oral Maxillofac Surg 24 30–7 Occurrence Handle7782638

    PubMed  Google Scholar 

  29. NCCN practice guidelines for cancer of the head and neck, version 1.2000. Rockville, PA: The National Comprehensive Cancer Network, Inc.; 2000.

  30. HC Pillsbury M Clark (1997) ArticleTitleA rationale for therapy of the N0 neck Laryngoscope 107 1294–315 Occurrence Handle10.1097/00005537-199710000-00004 Occurrence Handle9331305

    Article  PubMed  Google Scholar 

  31. PJ van Diest HL Peterse PJ Borgstein (1999) ArticleTitlePathological investigation of sentinel lymph nodes Eur J Nucl Med 26 S43–9 Occurrence Handle10.1007/s002590050577 Occurrence Handle10199932

    Article  PubMed  Google Scholar 

  32. JE Gershenwald MI Colome JE Lee PF Mansfield C Tseng JJ Lee CM Balch MI Ross (1998) ArticleTitlePatterns of recurrence following a negative sentinel lymph node biopsy in 243 patients with stage I or II melanoma J Clin Oncol 6 2253–60

    Google Scholar 

  33. RJ Cote HF Peterson B Chaiwun RD Gelber A Goldhirsch M Castiglione-Gertsch B Gusterson AM Neville (1999) ArticleTitleRole of immunohistochemical detection of lymph node metastases in the management of breast cancer. International Breast Cancer Study Group Lancet 354 896–900 Occurrence Handle10.1016/S0140-6736(98)11104-2 Occurrence Handle10489948

    Article  PubMed  Google Scholar 

  34. P Hermanek RVP Hutter LH Sobin C Wittekind (1999) ArticleTitleClassification of isolated tumor cells and micrometastasis Cancer 86 2668–73 Occurrence Handle10.1002/(SICI)1097-0142(19991215)86:12<2668::AID-CNCR11>3.0.CO;2-R Occurrence Handle10594862

    Article  PubMed  Google Scholar 

  35. JC Alex DN Krag (1996) ArticleTitleThe gamma-probe-guided resection of radiolabeled primary lymph nodes Surg Oncol Clin N Am 5 33–41 Occurrence Handle8789492

    PubMed  Google Scholar 

  36. KT Pitman JT Johnson H Edington EL Barnes R Day RL Wagner EN Myers (1998) ArticleTitleLymphatic mapping with isosulfan blue dye in squamous cell carcinoma of the head and neck Arch Otolaryngol Head Neck Surg 124 790–3 Occurrence Handle9677115

    PubMed  Google Scholar 

  37. WM Koch MA Choti AC Civelek DW Eisele JR Saunders (1998) ArticleTitleGammaprobe-directed biopsy of the sentinel node in oral squamous cell carcinoma Arch Otolaryngol Head Neck Surg 124 455–9 Occurrence Handle9559696

    PubMed  Google Scholar 

  38. T Shoaib DS Soutar JE Prosser DJ Dunaway HW Gray GM McCurrach RG Bessent AG Robertson R Oliver DG MacDonald (1999) ArticleTitleA suggested method for sentinel node biopsy in squamous cell carcinoma of the head and neck Head Neck 21 728–33 Occurrence Handle10.1002/(SICI)1097-0347(199912)21:8<728::AID-HED8>3.0.CO;2-P Occurrence Handle10562686

    Article  PubMed  Google Scholar 

  39. JA Werner AA Dunne D Brandt A Ramaswamy C Kulkens BM Lippert BJ Folz K Joseph R Moll (1999) ArticleTitleStudies on significance of sentinel lymphadenectomy in pharyngeal and laryngeal carcinoma Laryngorhinootologie 78 663–70 Occurrence Handle10.1055/s-1999-8768 Occurrence Handle10666692

    Article  PubMed  Google Scholar 

  40. C Von Buchwald A Bilde T Shoaib G Ross (2002) ArticleTitleSentinel node biopsy: the technique and the feasibility in head and neck cancer ORL J Otorhinolaryngol Relat Spec 64 268–74 Occurrence Handle12232473

    PubMed  Google Scholar 

  41. T Shoaib DS Soutar DG MacDonald (2001) ArticleTitleThe accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck Cancer 91 2077–83 Occurrence Handle10.1002/1097-0142(20010601)91:11<2077::AID-CNCR1235>3.0.CO;2-E Occurrence Handle11391588

    Article  PubMed  Google Scholar 

  42. GL Ross T Shoaib DS Soutar DG MacDonald IG Camilleri RG Bessent HW Gray (2002) ArticleTitleThe first international conference on sentinel node biopsy in mucosal head and neck cancer and adoption of a multicenter trial protocol Ann Surg Oncol 9 406–10 Occurrence Handle10.1245/aso.2002.9.4.406 Occurrence Handle11986194

    Article  PubMed  Google Scholar 

  43. GL Ross DS Soutar T Shoaib IG Camilleri DG MacDonald AG Robertson RG Bessent HW Gray (2002) ArticleTitleThe ability of lymphoscintigraphy to direct sentinel node biopsy in the clinically N0 neck for patients with head and neck squamous cell carcinoma Br J Radiol 75 950–8 Occurrence Handle12515703

    PubMed  Google Scholar 

  44. Werner JA, Sapundzhiev NR, Teymoortash A, Dunne AA, Behr T, Folz BJ. Endoscopic sentinel lymphadenectomy as a new diagnostic approach in the N0 neck. Eur Arch Otorhinolaryngol 2004 Aug 22 [Epub ahead of print].

  45. S Asthana SV Deo NK Shukla P Jain M Anand R Kumar (2003) ArticleTitleIntraoperative neck staging using sentinel node biopsy and imprint cytology in oral cancer Head Neck 25 368–72 Occurrence Handle10.1002/hed.10211 Occurrence Handle12692873

    Article  PubMed  Google Scholar 

  46. L Tschopp M Nuyens E Stauffer T Krause P Zbaeren (2005) ArticleTitleThe value of frozen section analysis of the sentinel lymph node in clinically N0 squamous cell carcinoma of the oral cavity and oropharynx Otolaryngol Head Neck Surg 132 99–102 Occurrence Handle10.1016/j.otohns.2004.09.010 Occurrence Handle15632917

    Article  PubMed  Google Scholar 

  47. LJ DiNardo (1998) ArticleTitleLymphatics of the submandibular space: an anatomic, clinical, and pathologic study with applications to floor-of-mouth carcinoma Laryngoscope 108 206–14 Occurrence Handle10.1097/00005537-199802000-00009 Occurrence Handle9473069

    Article  PubMed  Google Scholar 

  48. JA Werner AA Dunne JN Myers (2003) ArticleTitleFunctional anatomy of the lymphatic drainage system of the upper aerodigestive tract and its role in metastasis of squamous cell carcinoma Head Neck 25 322–32 Occurrence Handle10.1002/hed.10257 Occurrence Handle12658737

    Article  PubMed  Google Scholar 

  49. JP Shah FC Candela AK Poddar (1990) ArticleTitleThe patterns of cervical lymph node metastases from squamous carcinoma of the oral cavity Cancer 66 109–13 Occurrence Handle2354399

    PubMed  Google Scholar 

  50. H Rouviere (1932) Anatomie des lymphatiques de l’homme Masson Paris

    Google Scholar 

  51. S Ozeki H Tashiro M Okamoto T Matsushima (1985) ArticleTitleMetastasis to the lingual lymph node in carcinoma of the tongue J Maxillofac Surg 13 277–81 Occurrence Handle10.1016/S0301-0503(85)80064-3 Occurrence Handle3866823

    Article  PubMed  Google Scholar 

  52. L Calabrese G Renne C De Cicco F Chiesa (2003) ArticleTitleMetastatic cancer to the floor of mouth: the lingual lymph nodes Head Neck 25 341–2 Occurrence Handle10.1002/hed.10259 Occurrence Handle12658740

    Article  PubMed  Google Scholar 

  53. M Tsuchimochi H Sakahara K Hayama M Funaki R Ohno T Shirahata T Orskaug G Maehlum K Yoshioka E Nygard (2003) ArticleTitleA prototype small CdTe gamma camera for radioguided surgery and other imaging applications Eur J Nucl Med Mol Imaging 30 1605–14 Occurrence Handle10.1007/s00259-003-1301-3 Occurrence Handle14504828

    Article  PubMed  Google Scholar 

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  1. Gary L. Ross

    Present address: , 14 Northen Grove, Didsbury, Manchester, M20 2WL, UK

Authors and Affiliations

  1. Canniesburn Plastic Surgery Unit, Jubilee Building, Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK

    Gary L. Ross & Taimur Shoaib

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  1. Gary L. Ross
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  2. Taimur Shoaib
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Correspondence to Gary L. Ross.

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Ross, G., Shoaib, T. Role of sentinel node biopsy in the management and staging of the N0 neck. Odontology 93, 1–6 (2005). https://doi.org/10.1007/s10266-005-0045-x

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