Distribution of sentinel nodes from parotid tumors–A feasibility study

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2023-09-30 DOI:10.1002/cam4.6612

Lalle Hammarstedt-Nordenvall, Rusana Bark, Alexandra Elliot, Mathias Von Beckerath, Caroline Gahm

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引用次数: 0

Abstract

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.

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腮腺肿瘤前哨淋巴结的分布——一项可行性研究。

背景：在腮腺癌症中，N0颈部的最佳治疗尚未解决。前哨淋巴结活检（SNB）可以可靠地检测显微镜下的淋巴结转移，其在头颈部肿瘤中的临床应用正在增加。本研究的目的是确定该技术是否适用于检测腮腺肿瘤前哨淋巴结的分布。材料和方法：对30例腮腺良性或低度恶性肿瘤T1-T2N0进行前瞻性观察研究。术前超声引导肿瘤周围注射锝-99（Tc-99 m）标记示踪剂，然后进行SPECT-CT和术中颈部和腮腺组织测量。在细胞学怀疑为恶性肿瘤或细胞学高度不清的患者中，也进行了SNB。结果：30例中有26例检出前哨淋巴结。其中，7例仅出现一个SN，而在19例中检测到多个前哨淋巴结。颈部1级未发现SN。SN在5级检测到，与腮腺内的肿瘤位置无关。在较大的肿瘤中，突触体内SNs的分布更为常见。结论：SN技术在腮腺肿瘤手术治疗计划中的应用是可行的。对腮腺癌症患者来说，更准确的分期和检测腮腺和颈部SNs的隐匿性转移可能具有临床价值，从而有可能在初次手术时通过手术切除所有阳性SNs，并降低手术发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.