[Optimized methods of sentinel node localization in cN0 tongue carcinoma].

ABSTRACT

BACKGROUND & OBJECTIVE: At present, there is no clinical examination and biochemical marker available to assess the lymph node status of tongue carcinoma with clinically negative neck (cN0) accurately. Therefore, the treatment of the cN0 neck in tongue carcinoma is of blind to some extent. Application of sentinel node(SN) biopsy may possibly bring about the individualized management of the cN0 neck of tongue carcinoma. This study was designed to assess whether lymph node status can be accurately evaluated by SN biopsy and to screen out the optimized sentinel node localization method. METHODS: Preoperative nuclear lymphoscintigraphy and intraoperative methylene blue dye mapping were performed in 24 cases of tongue carcinoma to reveal the efficacy of sentinel node biopsy in evaluating the lymph node status in cN0 tongue carcinoma. Shortcomings and advantages of lymphoscintigraphy, methylene blue dye mapping and combination of both methods were discussed. RESULTS: Sentinel nodes were detected in all cases with both methods. Sentinel nodes were found with metastasis in 4 cases. No non-sentinel node was found with metastasis while sentinel nodes were pathologically negative. The detection rates were 3.5 sentinel nodes per case by lymphoscintigraphy, and 2.7 by methylene blue dye, while only 2.2 sentinel nodes by combined methods. CONCLUSION: Either lymphoscintigraphy or methylene blue dye mapping can be used to assess the cervical lymph node status of cN0 tongue carcinoma accurately. Combination with both methods is the most efficient and practicable method in sentinel node detection.