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• W2258416156 abstract "Introduction: The elective neck treatment in patients with squamous cell carcinoma of head and neck is suitable when the neck is clinically negative and the probability of lymphatic metastasis is greater than 20%. However, with this criterion, up to 80% of surgical specimens will be histopathologically negative. The absence of a method that can determine which patient really presents lymphatic metastasis does not allow us not to perform elective neck dissection when there is high risk for lymphatic metastasis. The sentinel lymph node biopsy seems to be clinically safe as a staging procedure. Besides, this technique apparently removes all the metastatic lymph nodes, since only 3% to 5% of the necks would present lymphatic metastasis other than sentinel node and neck recurrence seems similar to that after elective neck dissection. Then, this technique could be justified even as therapeutically, without elective neck dissection, when this lymph node is histologically positive.Objective: The objective of this study was to use the sentinel node technique with lymphocintigraphy and “gamma probe” in patients with squamous cell carcinoma of head and neck, therapeutically, as selective surgical treatment of neck, in substitution to elective neck dissection in clinically negative necks.Case: Prospective clinical study was accomplished with 25 patients with squamous cell carcinoma of head and neck, staged as T1 to T3 of oral cavity, orpharynx, larynx and face’s skin, from May, 2005 to march, 2007. All of them were cN0, without previous treatment, with indication of elective neck dissection and radiologically negative at neck CT scan. Sentinel node was located and dissected off with handheld “gamma probe” and 2 was directed for histopathological exam and immuno histochemistry evaluation. In the presence of adverse prognostic factors in the primary tumor or multiple lymphatic metastases, patient was submitted to adjuvant radiation therapy. Subjects were followed after surgery monthly with clinical exam and half-yearly with neck CT scan.Results: The global cervical recurrence rate was 4% (1/25) and in stage IV patients was 25% (1/4). Seven out of 25 patients (28%) were sentinel node positive, six of whom were classified as N1 and one as N2. The average follow up time was eight months, with a range from one to eighteen months.Conclusion: The sentinel node biopsy stays as a promising method in the neck treatment in head and neck tumors. However, more follow up time, with more patients, is imperative to achieve significant results to establish the sentinel node biopsy without mandatory neck dissection as routine care of head and neck cancer patients with clinically negative necks." @default.
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• W2258416156 date "2015-11-06" @default.
• W2258416156 modified "2023-09-27" @default.
• W2258416156 title "Head and Neck Cancer Treatment with Sentinel Node Biopsy without Eletive Neck Dissection" @default.
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• W2258416156 doi "https://doi.org/10.15406/mojcr.2015.03.00059" @default.
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