Sentinel Lymph Node Evaluation in Squamous Cell Carcinoma of the Head and Neck

Stoeckli, Sandro J.; Steinert, H.; Pfaltz, Madeleine; Schmid, Stephan

doi:10.1067/mhn.2001.118074

Cited by 129 publications

(100 citation statements)

References 10 publications

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“…These results are comparable to the findings of other groups also applying radiological criteria for staging (Stoeckli et al, 2001;Barzan et al, 2002;Werner et al, 2002a). The better the staging methods are in detecting small metastases, the less occult metastases will be overlooked and the more valuable will be the impact of an additional sentinel lymph-node procedure.…”

Section: Discussionsupporting

confidence: 85%

“…Studies applying a radiolabelled tracer with or without additional blue dye, however, were promising. The majority of the studies reported results favouring the sentinel lymph-node concept (Koch et al, 1998;Shoaib et al, 1999Shoaib et al, , 2001Alex et al, 2000;Zitsch et al, 2000;Mozzillo et al, 2001;Stoeckli et al, 2001Stoeckli et al, , 2002Barzan et al, 2002;Werner et al, 2002a, b). Groups who worked with blue dye report of an extravasation of the blue dye into the tissue (Pitman et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

“…Groups who worked with blue dye report of an extravasation of the blue dye into the tissue (Pitman et al, 2002). Other authors detected stained sentinel nodes only in a minority of their patients (Stoeckli et al, 2001). Additionally, blue dye will stain the area around the primary tumour.…”

Section: Discussionmentioning

confidence: 99%

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Sentinel lymph-node biopsy in head and neck cancer

et al. 2004

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The aim of the study was to assess the diagnostic value of the sentinel node method in patients suffering from squamous cell carcinoma of the upper aerodigestive tract. In 50 patients with oral, pharyngeal or laryngeal carcinomas staged N0 up to 50 MBq technetium-99m colloid were injected peritumorally. Sentinel nodes were localised using a g-probe in the setting of an elective neck dissection. Pathological findings of sentinel nodes and corresponding neck specimens were compared. In 46 patients sentinel nodes were detected. Of these 34 patients were free of metastatic disease in the sentinel nodes and in the neck specimens. In 12 patients clinically occult metastases were found in the sentinel nodes. Three metastases were detected only after additional sectioning of the sentinel nodes. In four patients, a sentinel lymph node could not be localised. Our results support the sentinel node concept in head and neck cancer and a definition of the sentinel nodes as the three nodes with the highest activity. Careful clinical staging of the neck and thorough pathological evaluation of the sentinel nodes are necessary to avoid false-negative results.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Sentinel lymph-node biopsy in head and neck cancer

et al. 2004

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“…Mapping is performed using preoperative lymphoscintigraphy and a g-counting probe (62). Imaging procedures are similar to those used for breast cancer and melanoma, including dynamic and planar imaging and skin marking.…”

Section: Head and Neck Malignanciesmentioning

confidence: 99%

“…Lymph nodes can often be adequately localized with planar imaging alone (62,63). However, the anatomic complexity of the head and neck and the proximity of some primary lesions to SLNs and other important structures suggest SPECT/CT should be included in some cases (64,65).…”

Section: Head and Neck Malignanciesmentioning

confidence: 99%

Lymphoscintigraphy and Sentinel Nodes

2015

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) generic fundamentals of lymphoscintigraphy procedures of sentinel lymph node biopsy (SLNB) protocols; (2) specific injection and imaging components of SLNB protocols used in the management of patients with breast cancer, melanoma, and head and neck malignancies; and (3) specific indications of breast cancer, melanoma, and head and neck malignancies that suggest inclusion of a SLNB in the management of a patient.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through June 2018.It has been validated that sentinel lymph node biopsy (SLNB) shows whether a patient's breast cancer or melanoma has spread to regional lymph nodes. As a result, management of patients with these cancers has been revolutionized. SLNB has replaced axillary lymph node dissection (ALND) as the staging modality of choice for early breast cancer and has replaced complete lymph node dissection as the staging modality of choice for melanoma in patients whose SLNBs indicate no metastases. Recently concluded multicenter, randomized trials for breast cancer with 5-to 10-y outcome data have shown no significant differences in disease-free survival rates or overall survival rates between SLNB and ALND groups but have shown significantly lower morbidity with SLNB than with ALND. The lowest false-negative rates (5.5%-6.7%) were seen in studies that used preoperative lymphoscintigraphy and dual mapping during surgery. To assess the survival impact of SLNB in melanoma, the Multicenter Selective Lymphadenectomy Trial I was performed. Melanoma-specific survival rates were not different between subjects randomized to SLNB with lymphadenectomy for nodal metastasis on biopsy and subjects randomized to observation with lymphadenectomy for nodal relapse. However, the 10-y disease-free survival rates were better for the SLNB group than for the observation group, specifically among patients with intermediate-thickness melanomas or thick melanomas.

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