Condizione dei linfonodi del livello IIb del collo nel carcinoma squamoso della lingua in pazienti sottoposti a svuotamento linfonodale radicale modificato e a biopsia del linfonodo sentinella

Translated title of the contribution: Status of level IIb lymph nodes of the neck in squamous cell carcinoma of the oral tongue in patients who underwent modified radical neck dissection and lymph node sentinel biopsy

M. Manola, C. Aversa, L. Moscillo, S. Villano, E. Pavone, C. Cavallo, A. Mastella, F. Ionna

Research output: Contribution to journalArticle

Abstract

Status of lymph nodes of level IIb was examined to identify the incidence of nodal metastasis and the lymphatic drainage in squamous cell carcinoma of the oral tongue in patients undergoing modified radical neck dissection (MRND) and sentinel node biopsy (SNB). Overall, 72 patients were divided into two groups; 38 patients (Group A) of any T and N+ or T3-T4- N0 stage underwent MRND. The surgical specimens were sent to the Pathology Department, divided into specific levels (I, IIa, IIb, II, IV, V) and labelled. The remaining 34 patients (Group B) T1-T2 -N0 stage were submitted to SNB. The histological examination of the specimens of the two groups was performed by staining with haematoxylin and eosin several sections from each node at different levels and then using a molecular marker such as cytokeratin and Epithelial Membrane Antigen (EMA). In Group A: In N0 there were no occult metastases at level IIb; in N+ neck, 8 cases (33.3%) showed metastasis at level IIb (P = 0.04). Metastases at level IIb were observed only in combination with other levels (P = 0.03). In Group B, direct lymphatic drainage was found in 2 patients (5.9%) at level IIb. There were no occult metastases at level IIb. Out of the 54 sentinel nodes harvested, 4 lymph nodes (7.4%) were found to be metastatic; these 4 sentinel nodes were found respectively in 4 patients, 1 at level II, 3 at level II a with an occult metastasis rate of 11.7%. In conclusion, SNB has prospected a new concept of lymphatic drainage that is variable and individual. SNB has demonstrated that direct lymphatic drainage is possible to level II b. In our experience with early cancer of the tongue (T1-T2 NO), SNB aided with lympho-scintigraphy seems to be a good technique for staging the neck with minimal morbidity.

Original languageItalian
Pages (from-to)130-134
Number of pages5
JournalActa Otorhinolaryngologica Italica
Volume31
Issue number3
Publication statusPublished - Jun 2011

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Sentinel Lymph Node Biopsy
Neck Dissection
Tongue
Squamous Cell Carcinoma
Neck
Lymph Nodes
Neoplasm Metastasis
Drainage
Biopsy
Tongue Neoplasms
Lymphatic Metastasis
Mucin-1
Hematoxylin
Eosine Yellowish-(YS)
Keratins
cyhalothrin
Radionuclide Imaging
Pathology
Staining and Labeling
Morbidity

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

@article{969c49055f204ced8ed9a5879c0862b3,
title = "Condizione dei linfonodi del livello IIb del collo nel carcinoma squamoso della lingua in pazienti sottoposti a svuotamento linfonodale radicale modificato e a biopsia del linfonodo sentinella",
abstract = "Status of lymph nodes of level IIb was examined to identify the incidence of nodal metastasis and the lymphatic drainage in squamous cell carcinoma of the oral tongue in patients undergoing modified radical neck dissection (MRND) and sentinel node biopsy (SNB). Overall, 72 patients were divided into two groups; 38 patients (Group A) of any T and N+ or T3-T4- N0 stage underwent MRND. The surgical specimens were sent to the Pathology Department, divided into specific levels (I, IIa, IIb, II, IV, V) and labelled. The remaining 34 patients (Group B) T1-T2 -N0 stage were submitted to SNB. The histological examination of the specimens of the two groups was performed by staining with haematoxylin and eosin several sections from each node at different levels and then using a molecular marker such as cytokeratin and Epithelial Membrane Antigen (EMA). In Group A: In N0 there were no occult metastases at level IIb; in N+ neck, 8 cases (33.3{\%}) showed metastasis at level IIb (P = 0.04). Metastases at level IIb were observed only in combination with other levels (P = 0.03). In Group B, direct lymphatic drainage was found in 2 patients (5.9{\%}) at level IIb. There were no occult metastases at level IIb. Out of the 54 sentinel nodes harvested, 4 lymph nodes (7.4{\%}) were found to be metastatic; these 4 sentinel nodes were found respectively in 4 patients, 1 at level II, 3 at level II a with an occult metastasis rate of 11.7{\%}. In conclusion, SNB has prospected a new concept of lymphatic drainage that is variable and individual. SNB has demonstrated that direct lymphatic drainage is possible to level II b. In our experience with early cancer of the tongue (T1-T2 NO), SNB aided with lympho-scintigraphy seems to be a good technique for staging the neck with minimal morbidity.",
keywords = "Level IIb, Neck dissection, Neck metastasis, Oral squamous cell carcinoma, Sentinel node biopsy",
author = "M. Manola and C. Aversa and L. Moscillo and S. Villano and E. Pavone and C. Cavallo and A. Mastella and F. Ionna",
year = "2011",
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pages = "130--134",
journal = "Acta Otorhinolaryngologica Italica",
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TY - JOUR

T1 - Condizione dei linfonodi del livello IIb del collo nel carcinoma squamoso della lingua in pazienti sottoposti a svuotamento linfonodale radicale modificato e a biopsia del linfonodo sentinella

AU - Manola, M.

AU - Aversa, C.

AU - Moscillo, L.

AU - Villano, S.

AU - Pavone, E.

AU - Cavallo, C.

AU - Mastella, A.

AU - Ionna, F.

PY - 2011/6

Y1 - 2011/6

N2 - Status of lymph nodes of level IIb was examined to identify the incidence of nodal metastasis and the lymphatic drainage in squamous cell carcinoma of the oral tongue in patients undergoing modified radical neck dissection (MRND) and sentinel node biopsy (SNB). Overall, 72 patients were divided into two groups; 38 patients (Group A) of any T and N+ or T3-T4- N0 stage underwent MRND. The surgical specimens were sent to the Pathology Department, divided into specific levels (I, IIa, IIb, II, IV, V) and labelled. The remaining 34 patients (Group B) T1-T2 -N0 stage were submitted to SNB. The histological examination of the specimens of the two groups was performed by staining with haematoxylin and eosin several sections from each node at different levels and then using a molecular marker such as cytokeratin and Epithelial Membrane Antigen (EMA). In Group A: In N0 there were no occult metastases at level IIb; in N+ neck, 8 cases (33.3%) showed metastasis at level IIb (P = 0.04). Metastases at level IIb were observed only in combination with other levels (P = 0.03). In Group B, direct lymphatic drainage was found in 2 patients (5.9%) at level IIb. There were no occult metastases at level IIb. Out of the 54 sentinel nodes harvested, 4 lymph nodes (7.4%) were found to be metastatic; these 4 sentinel nodes were found respectively in 4 patients, 1 at level II, 3 at level II a with an occult metastasis rate of 11.7%. In conclusion, SNB has prospected a new concept of lymphatic drainage that is variable and individual. SNB has demonstrated that direct lymphatic drainage is possible to level II b. In our experience with early cancer of the tongue (T1-T2 NO), SNB aided with lympho-scintigraphy seems to be a good technique for staging the neck with minimal morbidity.

AB - Status of lymph nodes of level IIb was examined to identify the incidence of nodal metastasis and the lymphatic drainage in squamous cell carcinoma of the oral tongue in patients undergoing modified radical neck dissection (MRND) and sentinel node biopsy (SNB). Overall, 72 patients were divided into two groups; 38 patients (Group A) of any T and N+ or T3-T4- N0 stage underwent MRND. The surgical specimens were sent to the Pathology Department, divided into specific levels (I, IIa, IIb, II, IV, V) and labelled. The remaining 34 patients (Group B) T1-T2 -N0 stage were submitted to SNB. The histological examination of the specimens of the two groups was performed by staining with haematoxylin and eosin several sections from each node at different levels and then using a molecular marker such as cytokeratin and Epithelial Membrane Antigen (EMA). In Group A: In N0 there were no occult metastases at level IIb; in N+ neck, 8 cases (33.3%) showed metastasis at level IIb (P = 0.04). Metastases at level IIb were observed only in combination with other levels (P = 0.03). In Group B, direct lymphatic drainage was found in 2 patients (5.9%) at level IIb. There were no occult metastases at level IIb. Out of the 54 sentinel nodes harvested, 4 lymph nodes (7.4%) were found to be metastatic; these 4 sentinel nodes were found respectively in 4 patients, 1 at level II, 3 at level II a with an occult metastasis rate of 11.7%. In conclusion, SNB has prospected a new concept of lymphatic drainage that is variable and individual. SNB has demonstrated that direct lymphatic drainage is possible to level II b. In our experience with early cancer of the tongue (T1-T2 NO), SNB aided with lympho-scintigraphy seems to be a good technique for staging the neck with minimal morbidity.

KW - Level IIb

KW - Neck dissection

KW - Neck metastasis

KW - Oral squamous cell carcinoma

KW - Sentinel node biopsy

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