Therapeutic implications of sentinel lymph node biopsy in the staging of oral cancer
Therapeutic implications of sentinel lymph node biopsy in the staging of oral cancer
复制标题
前哨淋巴结活检对口腔癌分期的治疗意义
作者：
N. Mozzillo;F. Chiesa;C. Caracò;G. Botti;S. Lastoria;F. Longo;F. Ionna
口腔癌患者最重要的预后因素是淋巴结转移的存在。在没有淋巴结病变的情况下，颈部诊断的处理仍然存在争议，但前哨淋巴结活检（SLB）可能有助于解决这个问题。在那不勒斯的国家癌症研究所，我们对41例T1至T2口腔癌患者进行了SLB。所有患者均行淋巴显像检查。术中蓝染和伽马探针检查发现39例前哨淋巴结（SN）。4例（10%）患者有双重引流，7例（18%）患者有超出预期解剖部位的引流。SN的病理与根治性清扫所得淋巴结的完全一致证实了SLB是一种可靠的分期方法。自2001年1月以来，7例T1至T2口腔癌患者仅以SLB分期；改良根治性颈部清扫只在SN阳性的病例中进行。SN检出率为100%，5例SN阴性患者中位随访10个月后均无疾病。淋巴显像加SLB似乎是指导口腔癌患者颈部管理的一个很好的分期系统。在一项随机试验中，更多的患者和更长时间的随访将证实该手术的潜在分期价值，并确定哪些患者可能从保守方法中获益，避免根治性颈部清扫。
The most powerful prognostic factor in patients with oral cancer is the presence of lymph node metastases. The management of the neck at diagnosis in the absence of adenopathy is still controversial, but sentinel lymph node biopsy (SLB) may help resolve this issue. At the National Cancer Institute in Naples, we performed SLB in 41 patients with T1 to T2 oral cancer. All patients underwent lymphoscintigraphy. Intraoperative blue dye and gamma probe examination identified a sentinel node (SN) in 39 patients. Four patients (10%) had double drainage, and 7 (18%) had drainage beyond the expected anatomical site. Complete concordance between the pathology of the SN and nodes obtained from radical dissection confirmed SLB as a reliable staging procedure. Since January 2001, seven patients with T1 to T2 oral cancers have been staged with SLB only; modified radical neck dissection was carried out only in cases with a positive SN. The rate of SN identification was 100%, and all five cases with negative SNs were free of disease after a median follow-up of 10 months. Lymphoscintigraphy plus SLB seems to be a good staging system for guiding neck management in patients with oral cancer. A larger number of patients and a longer follow-up in a randomized trial will confirm the potential staging value of this procedure and determine which patients might benefit from a conservative approach that avoids radical neck dissection.
原发性皮肤黑色素瘤的淋巴标测和前哨淋巴结切除术。
影响因子：
3.3
作者：
Essner,Richard
通讯作者：
Essner,Richard