Sentinel lymph node biopsy with preoperative CT lymphography and intraoperative indocyanine green fluorescence imaging for N0 early tongue cancer: A long-term follow-up study
Sentinel lymph node biopsy with preoperative CT lymphography and intraoperative indocyanine green fluorescence imaging for N0 early tongue cancer: A long-term follow-up study
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DOI：
10.1016/j.jcms.2020.01.007
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发表时间：
2020-03-01
影响因子：
3.1
通讯作者：
Mitsudo, Kenji
中科院分区：
文献类型：
--
作者：
Ishiguro, Keita;Iwai, Toshinori;Mitsudo, Kenji
目的：本研究评估前哨淋巴结（SLN）活检与术前CT淋巴造影（CTL）和术中吲哚菁绿色（ICG）荧光成像对NO早期舌癌的有用性。方法：27例NO早期口腔舌癌患者接受了128-术前1天行多排螺旋CT扫描，在ICG荧光引导下对SLN进行活检。我们确定了CTL标记的SLN的位置和数量，并评估了CTL增强的SLN是否可以在术中识别为ICG荧光淋巴结。结果：27例患者中26例（96.3%）检出SLN。SLN的总数和平均数分别为41和1.5。所有经CTL增强的SLN均可在术中被识别为ICG荧光淋巴结。在ICG荧光引导下，仅1例未发现经CTL增强的SLN的患者发现2个SLN。27例患者中，5例（18.5%）SLN伴转移。中位随访时间为76个月（范围44-82个月）。在随访中，22例无SLN转移的患者中有3例有隐匿性颈淋巴结转移。结论：术前CTL联合术中ICG荧光显像对早期舌癌患者进行SLN活检是一种可行、可靠的方法，无需放射性同位素示踪剂。(C)2020年欧洲颅颌面外科协会。由爱思唯尔有限公司出版。保留所有权利。
Purpose: This study evaluated the usefulness of sentinel lymph node (SLN) biopsy with preoperative computed tomographic lymphography (CTL) and intraoperative indocyanine green (ICG) fluorescence imaging for NO early tongue cancer.Methods: Twenty-seven patients with NO early oral tongue cancer underwent CTL with a 128-slice multidetector row CT scanner to detect SLN on the day before resection of primary tumor and SLN biopsy under ICG fluorescence guidance. We identified the location and number of SLNs mapped by CTL and evaluated whether CTL-enhanced SLNs could be identified intraoperatively as ICG fluorescent lymph nodes. Prognosis was also evaluated.Results: SLNs were detected by CTL in 26 of 27 patients (96.3%). The total and mean numbers of SLNs were 41 and 1.5, respectively. All SLNs enhanced by CTL could be identified intraoperatively as ICG fluorescent lymph nodes. Two SLNs were found under ICG fluorescent guidance in only one patient without SLN enhanced by CTL. Among the 27 patients, five (18.5%) had SLN with metastasis. Median follow-up was 76 months (range 44-82 months). During follow-up, three of 22 patients without SLN metastasis had occult cervical lymph node metastasis. The 5-year overall survival rate was 100%.Conclusion: SLN biopsy with preoperative CTL and intraoperative ICG fluorescence imaging is a feasible and reliable procedure, without radioisotope tracers, for neck management in cases of early tongue cancer. (C) 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.