Sentinel lymph node mapping in post chemotherapy nonseminoma testicular cancer patients undergoing retroperitoneal lymph node dissection: A series of nine cases.

OBJECTIVES: Testicular germ cell cancers are the most common solid malignancy among young men at the age ranging between 14 and 35 years. In this study, we evaluated the feasibility of sentinel lymph node mapping using intraoperative injection of radiotracer in nonseminomatous testicular cancer patients with history of orchiectomy who were candidate for retroperitoneal lymph node dissection (RPLND) in post-chemotherapy setting. METHODS: Nine consecutive cases were included in the study. Technetium-99m-labelled phytate was injected in two divided doses in the stump of the spermatic cord, through transabdominal approach. A hand-held gamma probe was used for radio-guided retroperitoneal sentinel lymph node detection intraoperatively and confirming the location of the sentinel lymph nodes. RESULTS: Detection rate and the false negative rate were estimated as the main indices. The detection rate was 6/9 (66%) and the false negative rate was 0/2 (0%). Location of the dissected sentinel lymph nodes were interaortocaval (2 patients), internal iliac (1 patient), external iliac (1 patient), common iliac (2 patients), and paraaortic (1 patient). CONCLUSION: Sentinel lymph node mapping technique seems to be feasible and promising in post chemotherapy non-seminoma testis cancer patients who are candidate for RPLND; however, further larger studies are needed to increase and standardize the detection rate.

Sentinel lymph node mapping in breast cancer patients following neoadjuvant chemotherapy: systematic review and meta-analysis about head to head comparison of cN0 and cN + patients.

PURPOSE: The effectiveness of sentinel lymph node (SLN) mapping and biopsy following neoadjuvant chemotherapy (NAC) in axillary lymph node staging of breast cancer (BCa) patients with initial clinical node positive status (cN +) compared to clinical node negative status (cN0) is not yet known. The aim of this meta-analysis was to compare the accuracy of SLN mapping following NAC in cN + and cN0 BCa patients. METHODS: PubMed and Scopus were comprehensively reviewed to retrieve all the studies that performed SLN mapping/biopsy and standard axillary lymph node dissection on cN0 and cN + BCa patients following NAC. Pooled detection and false negative rates for N0 and N + patients including 95% confidence interval values (95% CI) were evaluated. Odds ratio (OR) and risk difference (RD) of SLN detection failure and false negative results were compared between two groups. RESULTS: A total of 27 articles were included for SLN detection rate evaluation and 17 for false negative assessment. The OR and RD of detection failure in N + group compared with N0 group following NAC were 2.22 (p = 0.00, 95% CI 1.4-3.4) and 4% (p = 0.00, 95% CI 2-6%), respectively. The OR and RD of false negative rate were 1.6 (p = 0.01, 95% CI 1-2.6) and 8% (p = 0.02, 95% CI 1-14%), respectively. CONCLUSION: SLN mapping in BCa patients following NAC shows high risk of detection failure and high false negative rate of SLN biopsy in cN + patients. In comparison with cN0 BCa patients, SLN mapping and biopsy after NAC was associated with almost two times higher odds of detection failure and false negative results in cN + patients; therefore, this method should not be recommended in this group of patients.

Sentinel lymph node biopsy in upper tract urothelial cancers: an experience with intraoperative radiotracer injection.

BACKGROUND: The feasibility of the sentinel node mapping in upper tract urothelial cancers (UTUC) was evaluated, using a radiotracer as the mapping material. MATERIAL AND METHODS: To identify the sentinel lymph nodes, 37 MBq of [99mTc] phytate was injected in five patients with the renal pelvis or ureter cancer, who were candidates for ureterectomy and lymphadenectomy. The radiotracer was injected in a peritumoral fashion following the surgical exposure of the tumour. The sentinel lymph nodes were detected using a handheld gamma probe. RESULTS: By intraoperatively injecting the radiotracer immediately after surgical exposure of the tumour, at least one sentinel lymph node could be detected in each patient, and the detection rate was 100%. The location of sentinel nodes was in the paracaval, renal hill, retro-aortic, para-aortic, common iliac, and external iliac areas, which was dependent on the tumour location. No false-negative case was identified. CONCLUSIONS: Sentinel node mapping is feasible in UTUC. Injection technique (intra-vesical approach vs peri-tumoral injection after exposure of the tumour) and location of the tumour (proximal vs distal) may affect the technique's feasibility.

Bowel visualization on the lymphoscintigraphy images of a bladder cancer patient due to inadvertent injection of the tracer in the rectal wall.

The effectiveness of the sentinel lymph node mapping in patients with Urothelial carcinoma of the bladder is under investigation. Single photon emission computed tomography (SPECT/CT) and intraoperative sentinel node biopsy using gamma probe are performed to detect the exact location of the sentinel lymph node to be dissected during the surgery. In this case report, a 73-year old man with high grade urothelial carcinoma was referred to our nuclear medicine department for SPECT/CT, four hours after injection of the radiotracer through cystoscopy. SPECT/CT could not reveal any sentinel node; however, one sentinel lymph node was detected and harvested in the right external iliac region during surgery. SPECT/CT revealed unusual accumulation of tracer in large bowel which was due to severe adhesion of rectum and bladder, and inadvertent injection of the radiotracer into the rectal wall. During the sentinel lymph node procedure, the tracer should be injected with extreme caution and lymphoscintigraphy post injection may help detection of any injection failures.

Under-correction or full correction of myopia? A meta-analysis

PURPOSE: To compare the effect of full-correction versus under-correction on myopia progression. METHODS: A literature search was performed in PubMed, Scopus, Science Direct, Ovid, Web of Science and Cochrane library. Methodological quality assessment of the literature was evaluated according to the Critical Appraisal Skills Program. Statistical analysis was performed using Comprehensive Meta-Analysis (version 2, Biostat Inc., USA). RESULTS: The present meta-analysis included six studies (two randomized controlled trials [RCTs] and four non-RCTs) with 695 subjects (full-correction group, n = 371; under-correction group, n = 324) aged 6 to 33 years. Using cycloplegic refraction, the pooled difference in mean of myopia progression was - 0.179 D [lower and higher limits: -0.383, 0.025], which was higher but not in full correction group as compared to under correction group (p = 0.085). Regarding studies using non-cycloplegic subjective refraction according to maximum plus for maximum visual acuity, the pooled difference in myopia progression was 0.128 D [lower and higher limits: -0.057, 0.312] higher in under-correction group compared with full-correction group (p = 0.175). Although, difference in myopia progression did not reach significant level in either cycloplegic or non-cycloplegic refraction. CONCLUSIONS: Our findings suggest that, myopic eyes which are fully corrected with non-cycloplegic refraction with maximum plus sphere, are less prone to myopia progression, in comparison to those which were under corrected. However, regarding cycloplegic refraction, further studies are needed to better understand these trends

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Under-correction or full correction of myopia? A meta-analysis.

PURPOSE: To compare the effect of full-correction versus under-correction on myopia progression. METHODS: A literature search was performed in PubMed, Scopus, Science Direct, Ovid, Web of Science and Cochrane library. Methodological quality assessment of the literature was evaluated according to the Critical Appraisal Skills Program. Statistical analysis was performed using Comprehensive Meta-Analysis (version 2, Biostat Inc., USA). RESULTS: The present meta-analysis included six studies (two randomized controlled trials [RCTs] and four non-RCTs) with 695 subjects (full-correction group, n=371; under-correction group, n=324) aged 6 to 33 years. Using cycloplegic refraction, the pooled difference in mean of myopia progression was - 0.179 D [lower and higher limits: -0.383, 0.025], which was higher but not in full correction group as compared to under correction group (p=0.085). Regarding studies using non-cycloplegic subjective refraction according to maximum plus for maximum visual acuity, the pooled difference in myopia progression was 0.128 D [lower and higher limits: -0.057, 0.312] higher in under-correction group compared with full-correction group (p=0.175). Although, difference in myopia progression did not reach significant level in either cycloplegic or non-cycloplegic refraction. CONCLUSIONS: Our findings suggest that, myopic eyes which are fully corrected with non-cycloplegic refraction with maximum plus sphere, are less prone to myopia progression, in comparison to those which were under corrected. However, regarding cycloplegic refraction, further studies are needed to better understand these trends.

Sentinel lymph node biopsy in muscle-invasive bladder cancer: single-center experience.

OBJECTIVE: In this study, the validity of sentinel node biopsy procedure as our index test was assessed and compared with bilateral pelvic lymphadenectomy for staging and detecting the regional lymph nodes metastasis in patients with muscle-invasive bladder cancer (MIBC). METHODS: Consecutive series of cases with T1-T4 urothelial MIBC were included. Following the injection of radiotracer, sentinel nodes were sought using a handheld gamma probe and all hot nodes were harvested. Bilateral pelvic lymphadenectomy was done for all patients following sentinel node biopsy. The tumor specimen, sentinel nodes, and excised lymph nodes were evaluated histopathologically. Same as the other midline tumors, detection rate and false negative rates were calculated using patient basis and side basis methods. RESULTS: By evaluating each patient as a unit of analysis, sentinel nodes were detected in 35 of 41 patients (85%), 13/16 (81%) of the neoadjuvant chemotherapy (NAC) and 22/25 (88%) of the no-neoadjuvant chemotherapy (No-NAC) participants. The false negative rate was 3/7 (42%): 1/3 (33%) for NAC, and 2/4 (50%) for No-NAC patients. By evaluating each hemipelvis as a unit of analysis, sentinel nodes were detected in 53 of 82 hemipelves (65%), 19/32 (66%) of the NAC, and 34/50 (68%) of the No-NAC hemipelves. No false-negative result was found by assessing each hemipelvis as a unit of analysis. CONCLUSIONS: Sentinel node biopsy is a feasible method for lymph node staging in MIBC, including patients with a history of NAC. To optimize the sensitivity, the decision regarding the lymphadenectomy is best to be based on the pathological status of sentinel node harvested from each hemipelvis separately as the unilateral finding of a sentinel node, does not rule out the possibility of metastatic involvement of contralateral pelvic lymph nodes.

Sentinel Node Biopsy in Urothelial Carcinoma of the Bladder: Systematic Review and Meta-Analysis.

OBJECTIVES: To determine the application of sentinel node biopsy in urothelial carcinoma of the bladder, we performed a systematic review and meta-analysis. METHODS: Pooled false negative rate and detection rate were presented using Meta-Disc (version 1.4), and comprehensive meta-analysis (version 2). Publication bias and heterogeneity were assessed using funnel plot, Cochrane Q test, and I2 index. RESULTS: The pooled detection rate was 91% (95% CI 87-93%) and pooled sensitivity was 79% (95% CI 0.69-0.86%). When the neoadjuvant chemotherapy group of patients was omitted, the pooled sensitivity changed to 82% (95% CI 74-88%), and the Cochrane Q and I2 statistics were 15.44 and 48.2%, respectively. The pooled sensitivity of studies that included > 50% of pT 3 or 4 patients was 70% (59-80), by omitting studies that enrolled > 50% of patients at pT stage of 3 or 4, the pooled sensitivity increased to 93% (81-98). CONCLUSIONS: Although the studies on SN biopsy of muscle invasive bladder cancer patients resulted in a high detection rate and sensitivity, further validated multicenter trials with larger sample size are essential to confirm the reliability and accuracy of this approach and obtain a standardized method. We showed that pT1 or pT2 bladder cancer patients with clinically negative lymph nodes are the most appropriated group for sentinel lymph node mapping.

Concordance Between Intracervical and Fundal Injections for Sentinel Node Mapping in Patients With Endometrial Cancer?: A Study Using Intracervical Radiotracer and Fundal Blue Dye Injections.

OBJECTIVE: A major controversy in sentinel node (SN) biopsy of endometrial cancer is the injection site of mapping material. We compared lymphatic drainage pathways of the uterine cervix and uterine body in the same patients by head-to-head comparison of intracervical radiotracer and fundal blue dye injections. METHODS: All patients with pathologically proven endometrial cancer were included. Each patient received 2 intracervical injections of Tc-phytate. At the time of laparotomy, the uterus was exposed, and each patient was injected with 2 aliquots of patent blue V (2 mL each) in the subserosal fundal midline locations. The anatomical locations of all hot, blue, or hot/blue SNs were recorded. RESULTS: Overall, 45 patients entered the study. At least 1 SN could be identified in 75 of 90 hemipelves (83.3% overall detection rate, 82.2% for radiotracer [intracervical] alone, and 81.1% for blue dye [fundal] alone). In 71 hemipelves, SNs were identified with both blue dye (fundal) and radiotracer (intracervical) injections. In 69 of these 71 hemipelves, at least 1 blue/hot SN could be identified (97.18% concordance rate). In 10 patients, para-aortic SNs were identified. All of these nodes were identified by fundal blue dye injection, and only 2 were hot. CONCLUSIONS: Our study shows that lymphatic drainage to the pelvic area from the uterine corpus matches the lymphatic pathways from the cervix, and both intracervical and fundal injections of SN mapping materials go to the same pelvic SNs.

Comparison of cyclopentolate versus tropicamide cycloplegia: A systematic review and meta-analysis / Comparación de la cicloplejia con Ciclopentolato y Tropicamida: revisión sistemática y meta-análisis

Purpose: The aim of the present meta-analysis is to compare the efficacy of cyclopentolate and tropicamide in controlling accommodation during refraction. Methods: A comprehensive literature search was performed in PubMed, Scopus, Science direct and Ovid databases by the key words: "tropicamide"; "cyclopentolate"; "cycloplegia" and "cycloplegic" from inception to April 2016. Methodological quality of the literature was evaluated according to the Oxford Center for Evidence Based Medicine and modified Newcastle-Ottawa scale. Statistical analyses were performed using Comprehensive Meta-Analysis (version 2; Biostat Inc., USA). Results: The present meta-analysis included six studies (three randomized controlled trials and three case-control studies). Pooled standardized difference in the mean changes in the refractive error was 0.175 D [lower and upper limits: -0.089; 0.438] more plus in the cyclopentolate group compared to the tropicamide group; however, this difference was not statistically significant (p = 0.194; Cochrane Q value = 171.72 (p < 0.05); I2 = 95.34%). Egger's regression intercept was -5.33 (p = 0.170). Considering type of refractive errors; refractive assessment procedure and age group; although cycloplegic effect of cyclopentolate was stronger than tropicamide; however, this effect was only statistically significant in children; hyperopic patients and with retinoscopy. Conclusion: We suggest that tropicamide may be considered as a viable substitute for cyclopentolate due to its rapid onset of action. Although these results should be used cautiously in infants and in patients with high hyperopia or strabismus when using tropicamide as the sole cycloplegic agent especially in situations that the findings are variable or there is no consistency between the examination results and clinical manifestations of the visual problems

Objetivo: El objetivo del presente meta-análisis es comparar la eficacia de ciclopentolato y tropicamida a la hora de controlar la acomodación durante la refracción. Métodos: Se realizó una búsqueda amplia en la literatura en las bases de datos de PubMed, Scopus, Science direct y Ovid, utilizando las palabras clave: "tropicamida", "ciclopentolato", "cicloplejia" y "ciclopléjico" desde sus inicios a Abril de 2016. La calidad metodológica de la literatura se evaluó con arreglo a Oxford Center for Evidence Based Medicine y la escala Newcastle-Ottawa modificada. Los análisis estadísticos se realizaron utilizando el software Comprehensive Meta-Analysis (versión 2, Biostat Inc., EEUU). Resultados: El presente meta-análisis incluyó seis estudios (tres ensayos controlados aleatorizados y tres estudios de casos-control). La diferencia estandarizada combinada de los cambios medios del error refractivo fue de 0,175 D [límites inferior y superior: -0,089, 0,438], más acusada en el grupo ciclopentolato con respecto al grupo tropicamida aunque, sin embargo, esta diferencia no fue estadísticamente significativa (p = 0,194, Valor Q de Cochrane = 171,72 (p < 0,05), I2 = 95,34%). El valor del intercepto de regresión de Egger fue de -5,33 (p = 0,17). Considerando el tipo de errores refractivos, el procedimiento de valoración refractiva y el grupo de edad, aunque el efecto ciclopléjico de ciclopentolato fue más fuerte que el de tropicamida, dicho efecto fue únicamente significativo en niños, pacientes hipermétropes, y con retinoscopia. Conclusión: Sugerimos la consideración de tropicamida como sustituto viable de ciclopentolato, debido a su rápido inicio de acción. Aunque estos resultados deberían utilizarse con precaución en niños y en pacientes con elevada hipermetropía o estrabismo al utilizar tropicamida como único agente ciclopléjico, especialmente en situaciones en las que los hallazgos sean variables, o no exista consistencia entre los resultados del examen y las manifestaciones clínicas de los problemas visuales

Comparison of cyclopentolate versus tropicamide cycloplegia: A systematic review and meta-analysis.

PURPOSE: The aim of the present meta-analysis is to compare the efficacy of cyclopentolate and tropicamide in controlling accommodation during refraction. METHODS: A comprehensive literature search was performed in PubMed, Scopus, Science direct and Ovid databases by the key words: "tropicamide"; "cyclopentolate"; "cycloplegia" and "cycloplegic" from inception to April 2016. Methodological quality of the literature was evaluated according to the Oxford Center for Evidence Based Medicine and modified Newcastle-Ottawa scale. Statistical analyses were performed using Comprehensive Meta-Analysis (version 2; Biostat Inc., USA). RESULTS: The present meta-analysis included six studies (three randomized controlled trials and three case-control studies). Pooled standardized difference in the mean changes in the refractive error was 0.175 D [lower and upper limits: -0.089; 0.438] more plus in the cyclopentolate group compared to the tropicamide group; however, this difference was not statistically significant (p=0.194; Cochrane Q value=171.72 (p<0.05); I2=95.34%). Egger's regression intercept was -5.33 (p=0.170). Considering type of refractive errors; refractive assessment procedure and age group; although cycloplegic effect of cyclopentolate was stronger than tropicamide; however, this effect was only statistically significant in children; hyperopic patients and with retinoscopy. CONCLUSION: We suggest that tropicamide may be considered as a viable substitute for cyclopentolate due to its rapid onset of action. Although these results should be used cautiously in infants and in patients with high hyperopia or strabismus when using tropicamide as the sole cycloplegic agent especially in situations that the findings are variable or there is no consistency between the examination results and clinical manifestations of the visual problems.

Part-time versus full-time occlusion therapy for treatment of amblyopia: A meta-analysis.

PURPOSE: To compare full-time occlusion (FTO) and part-time occlusion (PTO) therapy in the treatment of amblyopia, with the secondary aim of evaluating the minimum number of hours of part-time patching required for maximal effect from occlusion. METHODS: A literature search was performed in PubMed, Scopus, Science Direct, Ovid, Web of Science and Cochrane library. Methodological quality of the literature was evaluated according to the Oxford Center for Evidence Based Medicine and modified Newcastle-Ottawa scale. Statistical analyses were performed using Comprehensive Meta-Analysis (version 2, Biostat Inc., USA). RESULTS: The present meta-analysis included six studies [three randomized controlled trials (RCTs) and three non-RCTs]. Pooled standardized difference in the mean changes in the visual acuity was 0.337 [lower and upper limits: -0.009, 0.683] higher in the FTO as compared to the PTO group; however, this difference was not statistically significant (P = 0.056, Cochrane Q value = 20.4 (P = 0.001), I2 = 75.49%). Egger's regression intercept was 5.46 (P = 0.04). The pooled standardized difference in means of visual acuity changes was 1.097 [lower and upper limits: 0.68, 1.513] higher in the FTO arm (P < 0.001), and 0.7 [lower and upper limits: 0.315, 1.085] higher in the PTO arm (P < 0.001) compared to PTO less than two hours. CONCLUSIONS: This meta-analysis shows no statistically significant difference between PTO and FTO in treatment of amblyopia. However, our results suggest that the minimum effective PTO duration, to observe maximal improvement in visual acuity is six hours per day.

Predictive value of red blood cell distribution width for mortality in patients with acute pancreatitis: A systematic review and meta-analysis.

Background: Red blood cell distribution width (RDW) is a quantitative measure of variability in the size of circulating erythrocytes. It has been recently identified as a prognostic marker in several diseases including acute pancreatitis (AP). In this systematic review the prognostic value of RDW in predicting mortality of AP patients will be assessed. Methods: PubMed, Scopus, EMBASE, and ISI databases were searched until September 2016 using the following search strategy: (pancreatitis OR pancreatitides) AND (RDW OR "red cell distribution width" OR "red blood cell distribution width" OR anisocytosis). Four authors independently reviewed the retrieved articles. Studies were included if they had evaluated the association between RDW value and mortality of acute pancreatitis patients. Case reports, comments, letters to the editor, reviews, study protocols, and experimental studies were not included. Data abstraction and quality assessment for the included studies was independently performed by two authors. Quality of studies was assessed using Oxford Center for Evidence-Based Medicine checklist for prognostic studies. Data were synthesized qualitatively, and a meta-analysis was performed on the diagnostic performance of RDW to predict mortality in AP patients. Results: Seven studies (976 patients) were included in the systematic review. Six studies reported a statistically significant association between RDW value and mortality. Meta-analysis was performed on four studies (487 patients) using a bivariate model and a summary receiver operating characteristic (sROC) curve was plotted with an area under the curve (AUC) of 0.757. The pooled diagnostic odds ratio (DOR), sensitivity and specificity was 19.51 (95% CI: 5.26-72.30), 67% (95% CI: 51%-80%) and 90% (95% CI: 73%-96%), respectively. Conclusion: RDW is an easy to use and an inexpensive marker with a moderate prognostic value to predict death in AP patients. Clinicians should be more alert when a patient with AP has an increased RDW. Investigation of possible combinations of other prognostic markers with RDW is recommended.

Lymphatic mapping and sentinel node biopsy in ovarian tumors: a study using intra-operative Tc-99m-Phytate and lymphoscintigraphy imaging.

BACKGROUND: Experience on sentinel node mapping in ovarian tumors is very limited. We evaluated the sentinel node concept in ovarian tumors using intra-operativeTc-99m-Phytate injection and lymphoscintigraphy imaging. METHODS: Thirty-five patients with a pelvic mass due to an ovarian pathology were included in the study. The radiotracer was injected just after laparotomy and before removal of the tumor either beneath the normal cortex (10 patients) or in the utero-ovarian and suspensory ligaments of the ovary just beneath the peritoneum two injections of the radiotracer (25 patients). For malignant masses, the sentinel nodes were identified using a hand held gamma probe. Then standard pelvic and para-aortic lymphadenectomy was performed. In case of benign pathologies or borderline ovarian tumors on frozen section, lymphadenectomy was not performed. The morning after surgery, all patients were sent for lymphoscintigraphy imaging of the abdomen and pelvis. RESULTS: Sentinel node was identified only in 4 patients of the cortical injection group. At least one sentinel node could be identified in 21 patients of the sub-peritoneal group. Sentinel nodes were identified only in the para-aortic area in 21, pelvic/para-aortic areas in 2, and pelvic only area in 2 patients. Three patients had lymph node involvement and all had involved sentinel nodes (no false negative case). CONCLUSION: Sentinel node mapping using intra-operative injection of the radiotracer (in the utero-ovarian and suspensory ligaments of the ovary just beneath the peritoneum) is feasible in ovarian tumors. Technical aspects of this method should be explored in larger multicenter studies in the future.

Lymphatic mapping and sentinel node biopsy in a patient with upper limb Merkel Cell Carcinoma: a case report and brief review of literature.

Sentinel node mapping is an integral part of regional lymph node staging in many solid tumors and plays an important role in surgical oncology. This technique has been used with excellent results for non-melanoma skin cancers including Merkel Cell Carcinoma (MCC). In the current study, we reported our first MCC patient who underwent successful sentinel node mapping. We also reviewed the available literature regarding the prognostic significance of sentinel node mapping in cN0 MCC patients.

Intra-Operative Lymphatic Mapping and Sentinel Node Biopsy in Laryngeal Carcinoma: Preliminary Results.

INTRODUCTION: Sentinel node mapping has been used for laryngeal carcinoma in several studies, with excellent results thus far. In the current study, we report our preliminary results on sentinel node mapping in laryngeal carcinoma using intra-operative peri-tumoral injection of a radiotracer. MATERIALS AND METHODS: Patients with biopsy-proven squamous cell carcinoma of the larynx were included in the study. Two mCi/0.4 cc Tc-99m-phytate in four aliquots was injected on the day of surgery, after induction of anesthesia, in the sub-mucosal peri-tumoral location using a suspension laryngoscopy. After waiting for 10 minutes, a portable gamma probe was used to search for sentinel nodes. All patients underwent laryngectomy and modified radical bilateral neck dissection. All sentinel nodes and removed non-sentinel nodes were examined by hematoxylin and eosin (H&E) staining. RESULTS: Ten patients with laryngeal carcinoma were included. At least one sentinel node could be detected in five patients (bilateral nodes in four patients). One patient had pathologically involved sentinel and non-sentinel nodes (no false-negative cases). CONCLUSION: Sentinel node mapping in laryngeal carcinoma is technically feasible using an intra-operative radiotracer injection. In order to evaluate the relationship of T-stage and the laterality of the tumor with accuracy, larger studies are needed.