Value of sentinel lymphonodectomy in head and neck cancer patients withoutevidence of lymphogenic metastatic disease

Objective: Only few communications deal with the value of sentinel node (SN ) biopsy for head and neck squamous cell carcinoma (HNSCC). Based on the re sults of 38 investigated patients with clinically NO-neck the feasibility o f SN biopsy in HNSCC is critically discussed. Patients and methods: Thirty- eight previously untreated patients with clinically NO-neck were staged by intraoperative SN biopsy. After intraoperative identification of the hottes t node (SN) and further less tracer accumulating lymph nodes (SN2. SN3). pa tients were treated by different types of neck dissection (ND), adjusted to the location and extent of the primary tumour. Postoperatively the histolo gic results of the SN1-3 and the entire ND specimen were compared. Results: The stage of cervical metastatic disease was demonstrated by a disease-fre e SN1 in 32 patients. In five patients an isolated metastasis could be prov en in the intraoperatively identified SN, while in the remaining patient an isolated metastasis was found in the SN2. Conclusion: Intraoperative SN bi opsy seems to be valuable for the detection of occult lymph node metastases in HNSCC. This method might help to limit the extent of ipsilateral ND, if used as an intraoperative staging procedure to investigate the first drain ing tracer accumulating lymph nodes (SN1-3). (C) 2001 Elsevier Science Irel and Ltd. All rights reserved.