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01-09-2008 | Head and Neck Oncology

Sentinel Node Concept in Clinically N0 Laryngeal and Hypopharyngeal Cancer

Authors: Masayuki Tomifuji, MD, Akihiro Shiotani, MD, Hirofumi Fujii, MD, Koji Araki, MD, Koichiro Saito, MD, Koji Inagaki, MD, Makio Mukai, MD, Yuko Kitagawa, MD, Kaoru Ogawa, MD

Published in: Annals of Surgical Oncology | Issue 9/2008

Abstract

Background

Sentinel nodes (SNs) are the lymph nodes that directly receive lymphatic flow from a primary cancer lesion. The SN concept implies that lymphatic metastasis initially occurs at SNs. SN navigation surgery can be introduced for cancers in which the SN concept is established. In SN navigation surgery, lymph node dissection beyond SNs can be omitted if SNs are metastasis free. Although the SN concept has been investigated frequently for oral and oropharyngeal cancer, it has so far been investigated less for laryngeal and hypopharyngeal cancer. In this study, we investigated whether the SN concept is applicable for laryngeal and hypopharyngeal cancer.

Methods

Twenty patients with T2–T4 and clinically N0 laryngeal and hypopharyngeal cancer were recruited. ^99mTc-phytate was injected into several sites surrounding the tumor on the day before surgery. Lymphoscintigrams were acquired from at least two different viewpoints. SNs were surveyed intraoperatively, and neck dissections including at least levels II, III, and IV were performed.

Results

SNs had occult metastases in five cases. In the remaining 15 cases, neither SNs nor other lymph nodes contained metastases, consistent with the SN concept. There was one false-negative case showing delayed nodal metastasis 2 years after initial surgery. The overall accuracy of the SN concept was 95%.

Conclusion

Our study shows that SN biopsy is a reliable strategy to determine correct lymph node status in N0 laryngeal and hypopharyngeal cancer. SN detection was valuable in evaluating the need for neck dissection, whether ipsilaterally or bilaterally.

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Title: Sentinel Node Concept in Clinically N0 Laryngeal and Hypopharyngeal Cancer
Authors: Masayuki Tomifuji, MD
Akihiro Shiotani, MD
Hirofumi Fujii, MD
Koji Araki, MD
Koichiro Saito, MD
Koji Inagaki, MD
Makio Mukai, MD
Yuko Kitagawa, MD
Kaoru Ogawa, MD
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 9/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-008-0008-x

2024 ASCO Annual Meeting

Springer Medicine

Sentinel Node Concept in Clinically N0 Laryngeal and Hypopharyngeal Cancer

Abstract

Background

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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