Role of sentinel lymph node biopsy in oral cancer
Identifieur interne : 003C32 ( Pmc/Checkpoint ); précédent : 003C31; suivant : 003C33Role of sentinel lymph node biopsy in oral cancer
Auteurs : L. Calabrese [Italie] ; R. Bruschini [Italie] ; M. Ansarin [Italie] ; G. Giugliano [Italie] ; C. De Cicco [Italie] ; F. Ionna [Italie] ; G. Paganelli [Italie] ; F. Maffini [Italie] ; Ja Werner [Allemagne] ; D. Soutar [Royaume-Uni]Source :
- Acta Otorhinolaryngologica Italica [ 0392-100X ] ; 2006.
Abstract
Squamous cell carcinoma of the oral cavity represents about 2% of all malignant neoplasms and 47% of those developing in the head and neck area. The tongue is the most common site involved, and this incidence is increasing mainly in young people, possibly related to human papilloma virus infections. Prognosis depends on the stage: the 5-year survival rate of tongue squamous cell carcinoma, whatever the T stage, is 73% in pN0 cases, 40% in patients with positive nodes without extracapsular spread (pN1 ECS-), and 29% when nodes are metastatic with extracapsular spread (pN1 ECS+: p ≥ 0.0001). Nodal micrometastases (cN0 pN1) are found in up to 50% of cN0 tongue squamous cell carcinoma patients operated on the neck. At present, no clinical, imaging staging modalities or biological markers are available to diagnose nodal micrometastases. The sentinel node biopsy has been tested since 1996 in order to find a solution to this problem. The sentinel node is the first node reached by the lymphatic stream, assuming an orderly and sequential drainage from the tumour site, and should be predictive of the nodal stage. According to the literature, sentinel node biopsy is a reliable technique in selected cN0 cases, but the procedure is still experimental and should not be performed outside validation trials. Successful application of sentinel node biopsy in the head and neck region requires surgical experience and specific technical devices, including pre-operative lymphoscintigraphy and intra-operative gamma-probe. Moreover, dynamic lymphoscintigraphy seems to be able to show the lymphatic stream from the primary tumour and could allow a selective neck dissection to be tailored thus reducing the related morbidity.
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PubMed: 17633153
PubMed Central: 2639993
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PMC:2639993Le document en format XML
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<front><div type="abstract" xml:lang="en"><title>Summary</title>
<p>Squamous cell carcinoma of the oral cavity represents about 2% of all malignant neoplasms and 47% of those developing in the head and neck area. The tongue is the most common site involved, and this incidence is increasing mainly in young people, possibly related to human papilloma virus infections. Prognosis depends on the stage: the 5-year survival rate of tongue squamous cell carcinoma, whatever the T stage, is 73% in pN0 cases, 40% in patients with positive nodes without extracapsular spread (pN1 ECS-), and 29% when nodes are metastatic with extracapsular spread (pN1 ECS+: p ≥ 0.0001). Nodal micrometastases (cN0 pN1) are found in up to 50% of cN0 tongue squamous cell carcinoma patients operated on the neck. At present, no clinical, imaging staging modalities or biological markers are available to diagnose nodal micrometastases. The sentinel node biopsy has been tested since 1996 in order to find a solution to this problem. The sentinel node is the first node reached by the lymphatic stream, assuming an orderly and sequential drainage from the tumour site, and should be predictive of the nodal stage. According to the literature, sentinel node biopsy is a reliable technique in selected cN0 cases, but the procedure is still experimental and should not be performed outside validation trials. Successful application of sentinel node biopsy in the head and neck region requires surgical experience and specific technical devices, including pre-operative lymphoscintigraphy and intra-operative gamma-probe. Moreover, dynamic lymphoscintigraphy seems to be able to show the lymphatic stream from the primary tumour and could allow a selective neck dissection to be tailored thus reducing the related morbidity.</p>
</div>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Acta Otorhinolaryngol Ital</journal-id>
<journal-id journal-id-type="publisher-id">Acta</journal-id>
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<issn pub-type="ppub">0392-100X</issn>
<issn pub-type="epub">1827-675X</issn>
<publisher><publisher-name>Pacini Editore SpA</publisher-name>
<publisher-loc>Ospedaletto (Pisa), Italy</publisher-loc>
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<article-id pub-id-type="pmc">2639993</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
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<title-group><article-title>Role of sentinel lymph node biopsy in oral cancer</article-title>
<trans-title-group xml:lang="it"><trans-title>Il ruolo del linfonodo sentinella nel carcinoma del cavo orale</trans-title>
</trans-title-group>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Calabrese</surname>
<given-names>L</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bruschini</surname>
<given-names>R</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ansarin</surname>
<given-names>M</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Giugliano</surname>
<given-names>G</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>De Cicco</surname>
<given-names>C</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ionna</surname>
<given-names>F</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Paganelli</surname>
<given-names>G</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Maffini</surname>
<given-names>F</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
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<contrib contrib-type="author"><name><surname>Werner</surname>
<given-names>JA</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Soutar</surname>
<given-names>D</given-names>
</name>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<aff id="A1"><label>1</label>
Department of Head and Neck Surgery, European Institute of Oncology, Milan, Italy</aff>
<aff id="A2"><label>2</label>
Department of Nuclear Medicine, European Institute of Oncology, Milan, Italy</aff>
<aff id="A3"><label>3</label>
Department of Pathology, European Institute of Oncology, Milan, Italy</aff>
<aff id="A4"><label>4</label>
Department of Maxillo-Facial Surgery, National Cancer Institute, Fondazione Pascale, Naples, Italy</aff>
<aff id="A5"><label>5</label>
Department of Otolaryngology, Head & Neck Surgery, Philipps University, Marburg, Germany</aff>
<aff id="A6"><label>6</label>
Department of Plastic Surgery, Canniesburn Hospital, Glasgow, UK</aff>
</contrib-group>
<author-notes><corresp>Address for correspondence: Dr. L. Calabrese
<institution>Divisione Chirurgia Cervico-Facciale, Istituto Europeo di Oncologia</institution>
<addr-line>via Ripamonti 435, 20141 Milano</addr-line>
<country>Italy</country>
<email>luca.calabrese@ieo.it</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>12</month>
<year>2006</year>
</pub-date>
<volume>26</volume>
<issue>6</issue>
<fpage>345</fpage>
<lpage>349</lpage>
<history><date date-type="received"><day>30</day>
<month>9</month>
<year>2006</year>
</date>
<date date-type="accepted"><day>19</day>
<month>10</month>
<year>2006</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2006 by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Roma Italy</copyright-statement>
<copyright-year>2006</copyright-year>
</permissions>
<abstract><title>Summary</title>
<p>Squamous cell carcinoma of the oral cavity represents about 2% of all malignant neoplasms and 47% of those developing in the head and neck area. The tongue is the most common site involved, and this incidence is increasing mainly in young people, possibly related to human papilloma virus infections. Prognosis depends on the stage: the 5-year survival rate of tongue squamous cell carcinoma, whatever the T stage, is 73% in pN0 cases, 40% in patients with positive nodes without extracapsular spread (pN1 ECS-), and 29% when nodes are metastatic with extracapsular spread (pN1 ECS+: p ≥ 0.0001). Nodal micrometastases (cN0 pN1) are found in up to 50% of cN0 tongue squamous cell carcinoma patients operated on the neck. At present, no clinical, imaging staging modalities or biological markers are available to diagnose nodal micrometastases. The sentinel node biopsy has been tested since 1996 in order to find a solution to this problem. The sentinel node is the first node reached by the lymphatic stream, assuming an orderly and sequential drainage from the tumour site, and should be predictive of the nodal stage. According to the literature, sentinel node biopsy is a reliable technique in selected cN0 cases, but the procedure is still experimental and should not be performed outside validation trials. Successful application of sentinel node biopsy in the head and neck region requires surgical experience and specific technical devices, including pre-operative lymphoscintigraphy and intra-operative gamma-probe. Moreover, dynamic lymphoscintigraphy seems to be able to show the lymphatic stream from the primary tumour and could allow a selective neck dissection to be tailored thus reducing the related morbidity.</p>
</abstract>
<trans-abstract xml:lang="it"><title>Riassunto</title>
<p>I carcinomi del cavo orale rappresentano circa il 2% di tutte le neoplasie maligne ed il 47% di quelle del distretto cervico-facciale. La lingua è la sede più coinvolta e l’ incidenza dei carcinomi linguali è in aumento in tutto il mondo soprattutto nei giovani, probabilmente per la presenza di infezioni virali da papilloma virus. La prognosi di queste neoplasie dipende dallo stadio ed in particolare dallo stato dei linfonodi: la sopravvivenza a 5 anni è del 73% nei casi N0, del 40% in quelli con metastasi contenute nei linfonodi e del 29% nei casi con rottura della capsula linfonodale. Il problema clinico emergente è la diagnosi clinica pre-operatoria dei linfonodi micrometastatici. Infatti oggi non esiste alcun metodo clinico o per immagini e neppure markers affidabili per identificare questi linfonodi. Il linfonodo sentinella, ovvero il primo linfonodo raggiunto dal flusso linfatico partito dal focolaio tumorale, potrebbe risolvere questo problema diagnostico. La revisione della letteratura conferma questa ipotesi. Tuttavia questa tecnica deve essere ancora considerata sperimentale ed essere applicata solo nell’ ambito di studi clinici controllati. Essa richiede esperienza chirurgica e necessita di una linfoscintigrafia pre-operatoria e di una gamma camera portatile per identificare nel corso dell’ intervento il linfonodo sentinella. È anche allo studio una valutazione dinamica del flusso linfatico dalla neoplasia per identificare i livelli raggiunti in ogni singolo paziente: se questa ipotesi venisse confermata si potrebbe programmare una linfoadenectomia selettiva personalizzata.</p>
</trans-abstract>
<kwd-group><kwd>Squamous cell carcinoma</kwd>
<kwd>Oral cavity</kwd>
<kwd>Nodal metastases</kwd>
<kwd>Sentinel node</kwd>
</kwd-group>
</article-meta>
</front>
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<affiliations><list><country><li>Allemagne</li>
<li>Italie</li>
<li>Royaume-Uni</li>
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<region><li>District de Giessen</li>
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<li>Lombardie</li>
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<tree><country name="Italie"><region name="Lombardie"><name sortKey="Calabrese, L" sort="Calabrese, L" uniqKey="Calabrese L" first="L" last="Calabrese">L. Calabrese</name>
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<name sortKey="Ansarin, M" sort="Ansarin, M" uniqKey="Ansarin M" first="M" last="Ansarin">M. Ansarin</name>
<name sortKey="Bruschini, R" sort="Bruschini, R" uniqKey="Bruschini R" first="R" last="Bruschini">R. Bruschini</name>
<name sortKey="De Cicco, C" sort="De Cicco, C" uniqKey="De Cicco C" first="C" last="De Cicco">C. De Cicco</name>
<name sortKey="Giugliano, G" sort="Giugliano, G" uniqKey="Giugliano G" first="G" last="Giugliano">G. Giugliano</name>
<name sortKey="Ionna, F" sort="Ionna, F" uniqKey="Ionna F" first="F" last="Ionna">F. Ionna</name>
<name sortKey="Maffini, F" sort="Maffini, F" uniqKey="Maffini F" first="F" last="Maffini">F. Maffini</name>
<name sortKey="Paganelli, G" sort="Paganelli, G" uniqKey="Paganelli G" first="G" last="Paganelli">G. Paganelli</name>
</country>
<country name="Allemagne"><region name="Hesse (Land)"><name sortKey="Werner, Ja" sort="Werner, Ja" uniqKey="Werner J" first="Ja" last="Werner">Ja Werner</name>
</region>
</country>
<country name="Royaume-Uni"><noRegion><name sortKey="Soutar, D" sort="Soutar, D" uniqKey="Soutar D" first="D" last="Soutar">D. Soutar</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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