Sentinel node biopsy in oral cavity cancer: Correlation with PET scan and immunohistochemistry

Abstract

BACKGROUND: Lymphoscintigraphy and sentinel node biopsy (LS/SNB) is a minimally invasive technique that samples first-echelon lymph nodes to predict the need for more extensive neck dissection. METHODS: We evaluated this technique in 18 oral cavity cancers, stages T1-T3, N0. Patients underwent CT and positron emission tomography (PET) of the neck, followed by LS/SNB, frozen section, immediate selective neck dissection, definitive histology, and immunoperoxidase staining for cytokeratin. Histopathology of the sentinel node was correlated with that of the neck specimen. RESULTS: There were 10 true positives: 6 identified on frozen section; 2 on permanent histology; and 2 only on immunoperoxidase staining. In six, the sentinel node was the only positive node. There were seven true negatives and one false negative. CONCLUSIONS: Gross tumor replacement of lymph node architecture may obstruct and redirect lymphatic flow. Overall LS/SNB holds promise for oral cancer.