Sentinel lymph node biopsy with preoperative CT lymphography and intraoperative indocyanine green fluorescence imaging for N0 early tongue cancer: A long-term follow-up study |
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| Affiliation: | 1. Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, 3–9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan;2. Department of Radiology, Yokohama City University Hospital, 3–9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan;1. Department of Oral and Craniomaxillofacial Science, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, People''s Republic of China;2. Department of Oral and Maxillofacial Surgery, 2nd Hospital of Lanzhou University, Lanzhou, People''s Republic of China;1. Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli” Naples, Italy;2. Department of Dermatology, University of Insubria, Varese, Italy;1. Health Sciences University, Konya Training and Research Hospital, Department of Otorhinolaryngology Head and Neck Surgery, Konya, Turkey;2. Necmettin Erbakan University, Meram Medical Faculty, Department of Otorhinolaryngology Head and Neck Surgery, Konya, Turkey;3. Selçuk University, Medical Faculty, Department of Medical Pathology, Konya, Turkey;1. Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria;2. Institute of Head and Neck Surgery, Evangelical Hospital, Vienna, Austria;1. Department of Radiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan;2. Department of Dermatology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan;3. Department of Pathology and Cell Biology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan;4. Department of Radiology, Nakagami Hospital, 610 Noborikawa, Okinawa, Okinawa 904-2195, Japan;5. Department of Radiology, Heartlife Hospital, 208, Iju, Nakagami-gun, Okinawa 901-2492, Japan;1. Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España;2. Department of Nuclear Medicine, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands;3. Department of Head & Neck Surgery and Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands;4. Department of Radiology, Leiden University Medical Centre, Leiden, Netherlands |
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| Abstract: | PurposeThis study evaluated the usefulness of sentinel lymph node (SLN) biopsy with preoperative computed tomographic lymphography (CTL) and intraoperative indocyanine green (ICG) fluorescence imaging for N0 early tongue cancer.MethodsTwenty-seven patients with N0 early oral tongue cancer underwent CTL with a 128-slice multi-detector row CT scanner to detect SLN on the day before resection of primary tumor and SLN biopsy under ICG fluorescence guidance. We identified the location and number of SLNs mapped by CTL and evaluated whether CTL-enhanced SLNs could be identified intraoperatively as ICG fluorescent lymph nodes. Prognosis was also evaluated.ResultsSLNs were detected by CTL in 26 of 27 patients (96.3%). The total and mean numbers of SLNs were 41 and 1.5, respectively. All SLNs enhanced by CTL could be identified intraoperatively as ICG fluorescent lymph nodes. Two SLNs were found under ICG fluorescent guidance in only one patient without SLN enhanced by CTL. Among the 27 patients, five (18.5%) had SLN with metastasis. Median follow-up was 76 months (range 44–82 months). During follow-up, three of 22 patients without SLN metastasis had occult cervical lymph node metastasis. The 5-year overall survival rate was 100%.ConclusionSLN biopsy with preoperative CTL and intraoperative ICG fluorescence imaging is a feasible and reliable procedure, without radioisotope tracers, for neck management in cases of early tongue cancer. |
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| Keywords: | Early oral cancer Sentinel lymph node Computed tomographic lymphography: indocyanine green Sentinel lymph node biopsy |
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