Distribution of sentinel nodes from parotid tumors-A feasibility study.

Autor: Hammarstedt-Nordenvall L; Department of Head and Neck Surgery, Medical Unit Head Neck Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden.; Department of Clinical Sciences Intervention and Technology, Division of Ear Nose and Throat Diseases, Karolinska Institute, Stockholm, Sweden., Bark R; Department of Head and Neck Surgery, Medical Unit Head Neck Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden.; Department of Clinical Sciences Intervention and Technology, Division of Ear Nose and Throat Diseases, Karolinska Institute, Stockholm, Sweden., Elliot A; Department of Head and Neck Surgery, Medical Unit Head Neck Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden.; Department of Clinical Sciences Intervention and Technology, Division of Ear Nose and Throat Diseases, Karolinska Institute, Stockholm, Sweden., Von Beckerath M; Department of Head and Neck Surgery, Medical Unit Head Neck Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden.; School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden., Gahm C; Department of Head and Neck Surgery, Medical Unit Head Neck Lung and Skin Cancer, Karolinska University Hospital, Stockholm, Sweden.; Department of Clinical Sciences Intervention and Technology, Division of Ear Nose and Throat Diseases, Karolinska Institute, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Oct; Vol. 12 (19), pp. 19667-19672. Date of Electronic Publication: 2023 Sep 30.
DOI: 10.1002/cam4.6612
Abstrakt: Background: Optimum management of the N0 neck is unresolved in parotid salivary gland cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis and its´ clinical use is increasing for head and neck tumors. The object of this study was to establish whether the technique is applicable to detect distribution of sentinel nodes for parotid tumors.
Materials and Methods: Prosepective observational study in 30 patients with benign or low-grade T1-T2N0 malignant tumors in the parotid gland planned for surgical treatment. Distribution of SN was detected with a preoperative ultrasound-guided peritumoral injection with a technetium-99 (Tc-99 m) laballed tracer followed by a SPECT-CT and intraoperative measurement in the neck and parotidal tissue. In patients with cytologically suspected malignant tumor or highly unclerar cytology, SNB was also performed.
Results: Sentinel nodes (SNs) were detected in 26/30 cases. Out of these, 7 presented with only one SN, whereas multiple sentinel nodes where detected in 19 cases. No SNs were found in neck level 1. SN was detected in level 5 independent of tumor location within the parotid gland. An intraparotidal distribution of SNs was more frequent in larger tumors.
Conclusions: The use of SN-technique in the planning of surgical treatment of parotid tumors seems feasible. It may be of clinical value for patients with parotid cancer to enable a more accurate staging and to detect occult metastasis in the SNs within the parotid as well as in the neck, enabaling the possibility to surgically remove all positive SNs at primary surgery and with reduced surgical morbidity.
(© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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