Objectives: To determine the feasibility of sentinel node radiolocalization
in stage NO in head and neck squamous cell carcinoma and to gain insight a
s to whether the sentinel node could be prognostic of regional micrometasta
tic disease.
Study Design: A prospective report on the application sentinel node radiolo
calization in eight patients with NO squamous cell carcinoma of the head an
d neck region.
Methods: For each patient a peritumoral submucosal injection of filtered te
chnetium (Tc-99m) prepared with sulfur colloid was performed immediately fo
llowing intubation. After at least 30 minutes, focal areas of accumulation
corresponding to a sentinel node were marked on the skin surface. Complete
neck dissections were performed, and the sentinel nodes were identified for
later histological evaluation and comparison to the remaining lymphadenect
omy specimen.
Results: Sentinel node radiolocalization accurately identified two or more
sentinel lymph nodes in all eight cases. In one patient, two of the three l
ymph nodes containing micrometastatic disease were sentinel lymph nodes. Th
ere was no instance in which sentinel node was negative for micrometastatic
disease while being positive in a nonsentinel lymph node.
Conclusions: Accurate localization of the sentinel lymph node using radiola
beled sulfur-colloid is feasible in patients with squamous cell carcinoma o
f the head and neck region. Although sentinel node radiolocalization in hea
d and neck squamous cell cancer may potentially reduce the time, cost, and
morbidity of regional lymph node management, more experience with technique
is required before its role can be determined.