Study for sentinel lymph node detection by nuclear medical method in oral cancer

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Background and Aims : Sentinel lymph node navigation is expected to reduce the need for lymph node dissection in cancer surgery. We studied whether the sentinel lymph node concept is applicable to oral cancer.Patients and methods : Subjects were 7 patients with oral squamous cell carcinoma undergoing primary resection and neck dissection between April 2002 and July 2003. They were injected with 99mTc labeled phytate surrounding primary lesion for tracers preoperatively. Preoperative lymphoscintigraphy and intraoperative identification by gamma probe were done to detect sentinel lymph nodes. Dissected lymph nodes were examined histopathologically and nuclear-radiologically.Results : Sentinel lymph nodes were recognized at the submandibular region in all patients, and additional nodes at the cervical region in 3 cases. Metastatases were identified in 3 cases, one of whom had multiple metastases downstream from the sentinel lymph node. Another had further metastasis outside the dissection area.Conclusion : Sentinel lymph nodes are detected as described above and the sentinel lymph node concept is reasonable for oral cancer application.