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Sentinel node-assisted neck dissection in advanced oral squamous cell carcinoma-A new protocol for staging and treatment.
Bark, Rusana; Kolev, Aeneas; Elliot, Alexandra; Piersiala, Krzysztof; Näsman, Anders; Grybäck, Per; Georén, Susanna Kumlien; Wendt, Malin; Cardell, Lars Olaf; Margolin, Gregori; Marklund, Linda.
Afiliación
  • Bark R; Department of Clinical Sciences Intervention and Technology, Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden.
  • Kolev A; Medical Unit Head Neck Lung and Skin cancer, Department of Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden.
  • Elliot A; Department of Clinical Sciences Intervention and Technology, Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden.
  • Piersiala K; Medical Unit Head Neck Lung and Skin cancer, Department of Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden.
  • Näsman A; Department of Clinical Sciences Intervention and Technology, Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden.
  • Grybäck P; Medical Unit Head Neck Lung and Skin cancer, Department of Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden.
  • Georén SK; Department of Clinical Sciences Intervention and Technology, Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden.
  • Wendt M; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
  • Cardell LO; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
  • Margolin G; Department of Clinical Pathology, Karolinska University Hospital, Stockholm, Sweden.
  • Marklund L; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Cancer Med ; 12(11): 12524-12534, 2023 06.
Article en En | MEDLINE | ID: mdl-37084007
ABSTRACT

BACKGROUND:

Sentinel lymph node biopsy (SLNB) is used to improve the staging of and guide treatment in patients with early-stage T1-T2 N0 oral squamous cell carcinoma (OSCC). The role of sentinel nodes (SNs) and the use of SN-technique in advanced OSCC (T3-T4 and/or N+) remain to be evaluated. This study investigates the nodal drainage and the rate of positive SNs (SNs+) in all stages of OSCC. MATERIALS AND

METHODS:

In total, 85 patients with T1-T4 OSCC diagnosed 2019-2021 were included. We used a prolonged interval between peritumoral injection of radionuclide and SPECT-CT to include all SNs.

RESULTS:

Patients with advanced OSCC presented a higher proportion of contralateral lymphatic drainage and a higher rate of SN+ compared to patients with early-stage disease. T3-T4 and N+ tumors presented a tendency for a higher rate of contralateral lymphatic drainage compared to T1-T2 and N0 tumors (p = 0.1). The prevalence of positive nodes (SNs+) was higher among patients with advanced disease, T3-T4 versus T1-T2 (p = 0.0398).

CONCLUSION:

SN-assisted ND enables identification and removal of all SNs + and has the potential for more accurate staging and could possibly give prognostic advantages regarding regional recurrence for all OSCC patients, especially among those with advanced disease. The precise localization of the SNs + also suggests that a more individualized ND approach might be possible in the future even for patients with advanced OSCC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Boca / Carcinoma de Células Escamosas / Neoplasias de Cabeza y Cuello Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Cancer Med Año: 2023 Tipo del documento: Article País de afiliación: Suecia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Boca / Carcinoma de Células Escamosas / Neoplasias de Cabeza y Cuello Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Cancer Med Año: 2023 Tipo del documento: Article País de afiliación: Suecia
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