Value of sentinel lymphonodectomy in head and neck cancer patients without evidence of lymphogenic metastatic disease

Objective: Only few communications deal with the value of sentinel node (SN) biopsy for head and neck squamous cell carcinoma (HNSCC). Based on the results of 38 investigated patients with clinically N0-neck the feasibility of SN biopsy in HNSCC is critically discussed. Patients and methods: Thirty-eight previously untreated patients with clinically N0-neck were staged by intraoperative SN biopsy. After intraoperative identification of the hottest node (SN 1) and further less tracer accumulating lymph nodes (SN 2, SN 3), patients were treated by different types of neck dissection (ND), adjusted to the location and extent of the primary tumour. Postoperatively the histologic results of the SN 1–3 and the entire ND specimen were compared. Results: The stage of cervical metastatic disease was demonstrated by a disease-free SN 1 in 32 patients. In five patients an isolated metastasis could be proven in the intraoperatively identified SN 1, while in the remaining patient an isolated metastasis was found in the SN 2. Conclusion: Intraoperative SN biopsy seems to be valuable for the detection of occult lymph node metastases in HNSCC. This method might help to limit the extent of ipsilateral ND, if used as an intraoperative staging procedure to investigate the first draining tracer accumulating lymph nodes (SN 1–3).