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01-11-2005 | Original Articles

The Second International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer

Authors: Sandro J. Stoeckli, MD, Madeleine Pfaltz, MD, Gary L. Ross, MD, Hans C. Steinert, MD, D. G. MacDonald, FRCPath, Christian Wittekind, MD, David S. Soutar, MD

Published in: Annals of Surgical Oncology | Issue 11/2005

Abstract

Background

The Second International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer was hosted by the Department of Otorhinolaryngology, Head and Neck Surgery of the University Hospital in Zurich, Switzerland, from September 12 to 13, 2003. The aims of this conference were to present the results of validation studies and to achieve a consensus on methodological requirements.

Methods

More than 80 delegates from 20 countries attended the conference. The presented validation studies were summarized and compared with the literature. Consensus was achieved concerning requirements for lymphatic mapping and histopathologic work-up.

Results

Twenty centers presented results on 379 patients with cN0 disease. Sentinel nodes were identified in 366 (97%) of 379. Of these 366, 103 (29%) were positive for occult metastasis, and 263 (71%) were negative. Of those 263 patients, 11 patients (4%) showed nodal disease not revealed by the sentinel lymph node biopsy (SNB). The negative predictive value of a negative sentinel node for the remaining neck was 96%. The consensus conference resulted in the use of a radiotracer, lymphoscintigraphy, and a handheld gamma probe for lymphatic mapping as minimal requirements. The use of conventional hematoxylin and eosin staining and immunohistochemistry for cytokeratin is mandatory. Step-sectioning of the entire node at intervals of 150 μm is recommended.

Conclusions

The conference attracted delegates from all over the world, thus underscoring the high interest in the topic. With regard to the presented data and the data from the literature, SNB for early oral and oropharyngeal cancer is sufficiently validated. The consensus conference resulted in the definition of minimal methodological requirements for accurate SNB.

Morton DL, Duan-Ren W, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392–9

Krag DN, Weaver DL, Alex JC, Fairbank JT. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe. Surg Oncol 1993;2:335–40CrossRef

Alex JC, Sasaki CT, Krag DN, Wenig B, Pyle PB. Sentinel lymph node radiolocalization in head and neck squamous cell carcinoma. Laryngoscope 2000;110:198–203CrossRef

Shoaib T, Soutar DS, Prosser JE, et al. A suggested method for sentinel node biopsy in squamous cell carcinoma of the head and neck. Head Neck 1999;21:728–33CrossRef

Stoeckli SJ, Steinert H, Pfaltz M, Schmid S. Sentinel lymph node evaluation in squamous cell carcinoma of the head and neck. Otolaryngol Head Neck Surg 2001;125:221–6CrossRef

Civantos FJ, Gomez C, Duque C, et al. Sentinel node biopsy in oral cavity cancer: correlation with PET scan and immunohistochemistry. Head Neck 2003;25:1–9CrossRef

Barzan L, Sulfaro S, Alberti F, et al. Gamma probe accuracy in detecting the sentinel lymph node in clinically N0 squamous cell carcinoma of the head and neck. Ann Otol Rhinol Laryngol 2002;111:794–8

Mozzillo N, Chiesa F, Botti G, et al. Sentinel node biopsy in head and neck cancer. Ann Surg Oncol 2001;8(9 Suppl):103–5

Ross GL, Shoaib T, Soutar DS, et al. The first international conference of sentinel node biopsy in mucosal head and neck cancer and adoption of a multicenter trial protocol. Ann Surg Oncol 2002;9:406–10CrossRef

10.

Ross GL, Soutar DS, MacDonald G, et al. Sentinel node biopsy in head and neck cancer: preliminary results of a multicenter trial. Ann Surg Oncol 2004;11:690–6CrossRef

11.

Ross G, Shoaib T, Soutar D, et al. The use of sentinel node biopsy to upstage the clinically N0 neck in head and neck cancer. Arch Otolaryngol Head Neck Surg 2002;128:1287–91

12.

Ross GL, Soutar D, MacDonald DG, Shoaib T, Camilleri IG. Improved staging of cervical metastasis in clinically negative patients with head and neck squamous cell carcinoma. Ann Surg Oncol 2004;11:213–8CrossRef

13.

Stoeckli SJ, Pfaltz M, Steinert H, Schmid S. Histopathological features of occult metastasis detected by sentinel lymph node biopsy in oral and oropharyngeal squamous cell carcinoma. Laryngoscope 2002;112:111–5CrossRef

14.

Werner JA, Dunne AA, Ramaswamy A, et al. The sentinel node concept in head and neck cancer: solution for the controversies in the N0 neck? Head Neck 2004;26:603–11CrossRef

15.

Sobin LH, Wittekind CH, eds. TNM Classification of Malignant Tumours. 6th ed. New York: Wiley, 2002

16.

Kovacs AF, Acker P, Berner U, Risse JH. Sentinel-Lymphknotenexstirpation. HNO 2001;49:646–53CrossRef

17.

Pitman KT, Johnson JT, Brown ML, Myers EN. Sentinel lymph node biopsy in head and neck squamous cell carcinoma. Laryngoscope 2002;112:2101–13CrossRef

18.

Shoaib T, Soutar DS, MacDonald DG, et al. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer 2001;91:2077–83CrossRef

19.

Pastore A, Turetta GD, Tarabini A, Turetta D, Feggi L, Pelucchi S. Sentinel lymph node analysis in squamous carcinoma of the oral cavity and oropharynx. Tumori 2002;88:S58–60

20.

Tschopp L, Nuyens M, Stauffer E, Krause T, Zbaeren P. The 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 2005;132:99–102CrossRef

21.

Asthana S, Deo SV, Shukla NK, Jain P, Anand M, Kumar R. Intraoperative neck staging using sentinel node biopsy and imprint cytology in oral cancer. Head Neck 2003;25:368–72CrossRef

22.

Ambrosch P, Brinck U. Detection of nodal micrometastases in head and neck cancer by serial sectioning and immunostaining. Oncology 1996;10:1221–6

23.

Woolgar JA. Micrometastasis in oral/oropharyngeal squamous cell carcinoma: incidence, histopathological features and clinical implications. Br J Oral Maxillofac Surg 1999;37:181–6CrossRef

24.

van den Brekel MW, van der Waal I, Meijer CJ, Freeman JL, Castelijns JA, Snow GB. The incidence of micrometastases in neck dissection specimens obtained from elective neck dissections. Laryngoscope 1996;106:987–91CrossRef

25.

Hermanek P, Hutter RVP, Sobin LH, Wittekind C. Classification of isolated tumor cells and micrometastasis. Cancer 1999;86:2668–73CrossRef

Title: The Second International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer
Authors: Sandro J. Stoeckli, MD
Madeleine Pfaltz, MD
Gary L. Ross, MD
Hans C. Steinert, MD
D. G. MacDonald, FRCPath
Christian Wittekind, MD
David S. Soutar, MD
Publication date: 01-11-2005
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 11/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/ASO.2005.11.024

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Second International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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