Sentinel-Lymphknoten bei Mundhöhlen- und Rachen-Tumoren

Zusammenfassung

Die Exzision von Sentinel-Lymphknoten bekommt eine zunehmende Bedeutung bei der Diagnostik von Mundhöhlen- und Oropharynx-Karzinomen im Falle eines klinischen N0-Halses. Die Wertigkeit der Sentinel-Lymphknoten-Biopsie als minimal-invasiver Staging-Methode des Halses bei T1-2-Tumoren kann aufgrund der jüngsten internationalen multizentrischen Studien als gesichert gelten. Die vorliegende Arbeit beschreibt die Technik und orientiert sich an den neuesten europäischen Leitlinien.

Abstract

The excision of sentinel lymph nodes has a growing relevance in the diagnosis of oral and oropharyngeal cancer in cases of clinical N0 necks. The validity of sentinel node biopsy as minimally invasive staging tool of the neck in T1-2 tumours can be considered as proven due to most recent international multicentre studies. The present paper describes the technique and follows the newest European guide lines.

Schlüsselwörter

Sentinel-Lymphknoten - Mundhöhlenkrebs - Kopf-Hals-Tumoren - Lymphoszintigrafie

Key words

sentinel lymph node - oral cancer - head and neck cancer - lymphoscintigraphy

Literatur

• 1 Morton DL, Wen DR, Wong JH. et al . Technical details of intraoperative lymphatic mapping for early stage melanoma.  Arch Surg. 1992;  127 392-399
• 2 Alex JC, Krag DN. Gamma-probe guided localization of lymph nodes.  Surg Oncol. 1993;  2 137-143
• 3 Kovács AF, Acker P, Berner U. et al . Sentinel-Lymphknoten-Exstirpation. Behandlungsmethode des N0-Halses bei Patienten mit oralen und oropharyngealen Karzinomen.  HNO. 2001;  49 646-653
• 4 Ross G, Shoaib T, Soutar DS. et al . The use of sentinel node biopsy to upstage the clinically N0 neck in head and neck cancer.  Arch Otolaryngol Head Neck Surg. 2002;  128 1287-1291
• 5 Mozzillo N, Chiesa F, Caraco C. et al . Therapeutic implications of sentinel lymph node biopsy in the staging of oral cancer.  Ann Surg Oncol. 2004;  11 (3 Suppl.) 263S-266S
• 6 Thomsen JB, Sorensen JA, Grupe P. et al . Staging N0 oral cancer: lymphoscintigraphy and conventional imaging.  Acta Radiol. 2005;  46 492-496
• 7 Nieuwenhuis EJ, Pijpers R, Castelijns JA. et al . Lymphoscintigraphic details of sentinel lymph node detection in 82 patients with squamous cell carcinoma of the oral cavity and oropharynx.  Nucl Med Commun. 2003;  24 651-656
• 8 Kontio R, Leivo I, Leppanen E. et al . Sentinel lymph node biopsy in oral cavity squamous cell carcinoma without clinically evident metastasis.  Head Neck. 2004;  26 16-21
• 9 Shoaib T, Soutar DS, Prosser JE. et al . A suggested method for sentinel node biopsy in squamous cell carcinoma of the head and neck.  Head Neck. 1999;  21 728-733
• 10 Civantos FJ, Moffat FL, Goodwin WJ. Lymphatic mapping and sentinel lymphadenectomy for 106 head and neck lesions: contrasts between oral cavity and cutaneous malignancy.  Laryngoscope. 2006;  112 (3 Pt 2 Suppl 109) 1-15
• 11 Kovács AF. Head and neck squamous cell carcinoma: sentinel node or selective neck dissection.  Surg Oncol Clin N Am. 2007;  16 81-100
• 12 Colnot DR, Nieuwenhuis EJC, van den Brekel MWM. et al . Head and neck squamous cell carcinoma: US-guide fine-needle aspiration of sentinel lymph nodes for improved staging – initial experience.  Radiology. 2001;  218 289-293
• 13 Tschopp L, Nuyens M, Stauer E. et al . The value of frozen section analysis of the sentinel lymph node in clinically N0 squamous cell carcinoma of the oral cavity and oropharynx.  Otolaryngol Head Neck Surg. 2005;  132 99-102
• 14 Asthana S, Deo SV, Shukla NK. et al . Intraoperative neck staging using sentinel node biopsy and imprint cytology in oral cancer.  Head Neck. 2003;  25 368-372
• 15 Werner JA, Dünne AA, Ramaswamy A. et al . Sentinel node detection in N0 cancer of the pharynx and larynx.  Br J Cancer. 2002;  87 711-715
• 16 Paleri V, Rees G, Arullendran P. et al . Sentinel node biopsy in squamous cell cancer of the oral cavity and oral pharynx: a diagnostic meta-analysis.  Head Neck. 2005;  27 739-747
• 17 Alkureishi LW, Burak Z, Alvarez JA. et al . The European Association of Nuclear Medicine (EANM) Oncology Committee and European Sentinel Node Biopsy Trial (SENT) Committee. Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma.  Eur J Nucl Med Mol Imaging. 2009;  36 1915-1936
• 18 Ross GL, Soutar DS, MacDonald DG. et al . Sentinel node biopsy in head and neck cancer: preliminary results of a multicenter trial.  Ann Surg Oncol. 2004;  11 690-696
• 19 Civantos FJ, Zitsch RP, Schuller DE. et al . Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial.  J Clin Oncol. 2010;  28 1395-1400
• 20 Kovács AF, Walendzik H, Döbert N. et al . Sentinel-Lymphonodektomie als Stagingmethode bei Mundhöhlen- und Oropharynxkarzinomen. Analyse von 70 Patienten.  HNO. 2005;  53 531-538
• 21 Byers RM, Weber RS, Andrews T. et al . Frequency and therapeutic implications of skip metastases in neck from squamous carcinoma of the oral tongue.  Head Neck. 1997;  19 14-19
• 22 Payoux P, Dekeister C, Lopez R. et al . Effectiveness of lymphoscintigraphic sentinel node detection for cervical staging of patients with squamous cell carcinoma of the head and neck.  J Oral Maxillofac Surg. 2005;  63 1091-1095
• 23 Thomsen JB, Sorensen JA, Grupe P. et al . Sentinel lymph node biopsy in oral cancer: validation of technique and clinical implications of added oblique planar lymphoscintigraphy and/or tomography.  Acta Radiol. 2005;  46 569-575
• 24 Kovács AF, Döbert N, Walendzik H. et al . The diagnostic role of radioactivity in sentinel nodes in oral and oropharyngeal cancer.  Cancer Biother Radiopharm. 2006;  21 535-543
• 25 Barzan L, Sulfaro S, Alberti F. et al . An extended use of the sentinel node in head and neck squamous cell carcinoma: results of a prospective study of 100 patients.  Acta Otorhinolaryngol Ital. 2004;  24 145-149
• 26 Chiesa F, Mauri S, Grana C. et al . Is there a role for sentinel node biopsy in early N0 tongue tumors?.  Surgery. 2000;  128 16-21
• 27 Kovács AF, Landes CA, Hamscho N. et al . Pattern of drainage in sentinel lymph nodes after intra-arterial chemotherapy for oral and oropharyngeal cancer.  J Oral Maxillofac Surg. 2005;  63 185-190
• 28 Ambrosch P, Kron M, Fischer G. et al . Micrometastases in carcinoma of the upper aerodigestive tract: detection, risk of metastasizing, and prognostic value of depth of invasion.  Head Neck. 1995;  17 473-479
• 29 Hamakawa H, Takemura K, Sumida T. et al . Histological study on pN upgrading of oral cancer.  Virchows Arch. 2000;  437 116-121
• 30 Schiefke F, Akdemir M, Weber A. et al . Function, postoperative morbidity, and quality of life after cervical sentinel node biopsy and after selective neck dissection.  Head Neck. 2009;  31 503-512

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