SENTINEL LYMPH NODE- A CAPTAIN IN THE MANAGEMENT OF ORAL SQUAMOUS CELL CARCINOMA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 51
Abstract
BACKGROUND Squamous cell carcinoma represents about 2-3% of all malignant neoplasms & 47% of those arising in Head & Neck area. Incidence of Oral Squamous Cell Carcinoma is increasing especially in young people. The status of lymph node involvement holds prime importance in the prognosis and therapy of Oral Squamous Cell Carcinoma (OSCC). The risk of neck metastasis depends on the site, size, grading and depth of infiltration of tumour. Neck dissection is the only surgical option for pathologic staging of neck in patients with OSCC. However, often a minimally invasive sentinel lymph node biopsy may be adequate. Sentinel Node biopsy is a novel useful technique alternative to neck dissection in the management of OSCC. Sentinel lymph node offers accurate staging with minimal morbidity. Selective excision, meticulous histopathological examination of sentinel lymph nodes play a very important role in preserving the surgical approach to a N0 carcinoma. Aim of this study was to evaluate the role of sentinel lymph node in staging and treatment of Oral Squamous Cell Carcinoma in a Tertiary cancer care center. MATERIALS & METHODS In diagnosed cases of Oral Squamous Cell Carcinoma, sentinel lymph node excision was done prior to planned radical neck dissection, to study its role in staging of OSCC. Localization of sentinel lymph nodes done by using methylene blue dye and their histopathological examination was done by following step serial sectioning to detect lymph nodal micro metastasis for appropriate staging and management. RESULTS 20 cases with diagnosis of Well Differentiated Oral Squamous Cell Carcinoma were taken for study. Number of sentinel lymph nodes varied from one to five. Out of 20 cases, sentinel lymph nodes were identified in 16 cases. In those 16 cases, 6 cases were positive for metastasis on routine histopathological evaluation. The remaining 10 cases which were negative for metastasis, were later subjected to step serial sectioning. After which 1 case turned out to be positive. CONCLUSION Centers practicing sentinel lymph node biopsy for staging of Oral Squamous Cell Carcinoma should have meticulous histopathological workup on the entire lymph node by using step serial sectioning and there by detect micro metastasis and isolated tumour cells if any, to avoid unnecessary radical neck dissection and postoperative morbidity associated with it.
Authors and Affiliations
Triveni Bhopal, Namdev Vadla, Sai Mallikarjun, Sree Lakshmi
Keywords
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- EP ID EP550479
- DOI 10.14260/jemds/2018/1206
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