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Sentinel lymph node biopsy using computed tomographic lymphography in patients with early tongue cancer.

Honda K, Ishiyama K, Suzuki S, Oumi E, Sato T, Kawasaki Y, Saito H, Ishikawa K - Acta Otolaryngol. (2015)

Bottom Line: CT images were obtained before and after injection of iopamidol into the peritumoral region and the SLN was identified as the first enhanced lymph node.By intraoperative frozen section examination, metastases to SLNs were found in 4 (14.3%) (T1N0, 1 patient; T2N0, 3 patients) of the 28 patients.Of these four, SLN micrometastases were found in one patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.

ABSTRACT

Conclusions: Because computed tomography (CT) lymphography provides preoperative images of anatomic relationships between a tumor, its associated lymph vessels, and the sentinel lymph node (SLN), it may aid in directing the SLN biopsy for management of early tongue cancer.

Objectives: SLN biopsy using a radioisotope (RI) generally has been performed in head and neck cancer. However, this method can be performed only at institutions that are licenced for its use. In this study, we evaluated the utility of performing SLN biopsy in patients with early tongue cancer using the newly developed technique of CT lymphography.

Methods: Enrolled in this study were 31 patients with T1N0 or T2N0 tongue cancer. CT images were obtained before and after injection of iopamidol into the peritumoral region and the SLN was identified as the first enhanced lymph node. SLN biopsy was performed using CT lymphographic guidance combined with blue dye injection.

Results: The SLN was detected by CT lymphography in 28 cases (90.3%). By intraoperative frozen section examination, metastases to SLNs were found in 4 (14.3%) (T1N0, 1 patient; T2N0, 3 patients) of the 28 patients. Of these four, SLN micrometastases were found in one patient.

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Related in: MedlinePlus

Therapeutic options and patient distribution: 31 patients with T1N0 or T2N0 tongue cancer were enrolled in this study. The day after the CT lymphography, sentinel lymph node (SLN) biopsy using CT lymphographic guidance combined with the blue dye method and glossectomy were performed in the 28 patients having identified SLNs with CT lymphography. When the SLN was negative for metastasis in T1N0 cases, only glossectomy without neck dissection (ND) was performed. For T2N0 cases, primary tumor resection with elective neck dissection (level I–III) was performed regardless of the presence of metastasis in the SLN.
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Figure 0003: Therapeutic options and patient distribution: 31 patients with T1N0 or T2N0 tongue cancer were enrolled in this study. The day after the CT lymphography, sentinel lymph node (SLN) biopsy using CT lymphographic guidance combined with the blue dye method and glossectomy were performed in the 28 patients having identified SLNs with CT lymphography. When the SLN was negative for metastasis in T1N0 cases, only glossectomy without neck dissection (ND) was performed. For T2N0 cases, primary tumor resection with elective neck dissection (level I–III) was performed regardless of the presence of metastasis in the SLN.

Mentions: SLN biopsy was performed under CT lymphographic guidance combined with patent blue dye injection. Just before SLN biopsy, 2 ml of 1% patent blue was injected into the peritumor area. The SLN biopsy was performed using a skin incision at the previous day’s SLN marker made in accordance with the CT lymphography images. The dyed node located just under this marker was defined as the SLN. When a blue dyed node was not detected, SLN biopsy was performed only by the CT lymphographic guidance. Intraoperative frozen section examination of the SLN was performed. When the SLN was negative for metastasis in T1N0 cases, only glossectomy without neck dissection was performed. For T2N0 cases, primary tumor resection with elective neck dissection (level I–III) was performed regardless of the presence of metastasis in the SLN, in order to check for non-SLN metastasis. With positive metastasis to the SLN, glossectomy and elective neck dissection were performed, guided by the area of lymph node involvement (Figure 3). When the SLN was not detected by the CT lymphography, elective neck dissection was recommended in the case of T2N0.


Sentinel lymph node biopsy using computed tomographic lymphography in patients with early tongue cancer.

Honda K, Ishiyama K, Suzuki S, Oumi E, Sato T, Kawasaki Y, Saito H, Ishikawa K - Acta Otolaryngol. (2015)

Therapeutic options and patient distribution: 31 patients with T1N0 or T2N0 tongue cancer were enrolled in this study. The day after the CT lymphography, sentinel lymph node (SLN) biopsy using CT lymphographic guidance combined with the blue dye method and glossectomy were performed in the 28 patients having identified SLNs with CT lymphography. When the SLN was negative for metastasis in T1N0 cases, only glossectomy without neck dissection (ND) was performed. For T2N0 cases, primary tumor resection with elective neck dissection (level I–III) was performed regardless of the presence of metastasis in the SLN.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4487571&req=5

Figure 0003: Therapeutic options and patient distribution: 31 patients with T1N0 or T2N0 tongue cancer were enrolled in this study. The day after the CT lymphography, sentinel lymph node (SLN) biopsy using CT lymphographic guidance combined with the blue dye method and glossectomy were performed in the 28 patients having identified SLNs with CT lymphography. When the SLN was negative for metastasis in T1N0 cases, only glossectomy without neck dissection (ND) was performed. For T2N0 cases, primary tumor resection with elective neck dissection (level I–III) was performed regardless of the presence of metastasis in the SLN.
Mentions: SLN biopsy was performed under CT lymphographic guidance combined with patent blue dye injection. Just before SLN biopsy, 2 ml of 1% patent blue was injected into the peritumor area. The SLN biopsy was performed using a skin incision at the previous day’s SLN marker made in accordance with the CT lymphography images. The dyed node located just under this marker was defined as the SLN. When a blue dyed node was not detected, SLN biopsy was performed only by the CT lymphographic guidance. Intraoperative frozen section examination of the SLN was performed. When the SLN was negative for metastasis in T1N0 cases, only glossectomy without neck dissection was performed. For T2N0 cases, primary tumor resection with elective neck dissection (level I–III) was performed regardless of the presence of metastasis in the SLN, in order to check for non-SLN metastasis. With positive metastasis to the SLN, glossectomy and elective neck dissection were performed, guided by the area of lymph node involvement (Figure 3). When the SLN was not detected by the CT lymphography, elective neck dissection was recommended in the case of T2N0.

Bottom Line: CT images were obtained before and after injection of iopamidol into the peritumoral region and the SLN was identified as the first enhanced lymph node.By intraoperative frozen section examination, metastases to SLNs were found in 4 (14.3%) (T1N0, 1 patient; T2N0, 3 patients) of the 28 patients.Of these four, SLN micrometastases were found in one patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.

ABSTRACT

Conclusions: Because computed tomography (CT) lymphography provides preoperative images of anatomic relationships between a tumor, its associated lymph vessels, and the sentinel lymph node (SLN), it may aid in directing the SLN biopsy for management of early tongue cancer.

Objectives: SLN biopsy using a radioisotope (RI) generally has been performed in head and neck cancer. However, this method can be performed only at institutions that are licenced for its use. In this study, we evaluated the utility of performing SLN biopsy in patients with early tongue cancer using the newly developed technique of CT lymphography.

Methods: Enrolled in this study were 31 patients with T1N0 or T2N0 tongue cancer. CT images were obtained before and after injection of iopamidol into the peritumoral region and the SLN was identified as the first enhanced lymph node. SLN biopsy was performed using CT lymphographic guidance combined with blue dye injection.

Results: The SLN was detected by CT lymphography in 28 cases (90.3%). By intraoperative frozen section examination, metastases to SLNs were found in 4 (14.3%) (T1N0, 1 patient; T2N0, 3 patients) of the 28 patients. Of these four, SLN micrometastases were found in one patient.

Show MeSH
Related in: MedlinePlus