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第52回・2014年・横浜
 

Sentinel Node Biopsy Provides a Useful Way of Deciding on Neck Dissection in Early Stage Carcinoma of the Tongue

演題番号 : P2-12

[筆頭演者]
Matsuzuka Takashi:1 
[共同演者]
Omori Koichi:1

1:Department of Otolaryngology, School of Medicine, Fukushima Medical University

 

Objective: To determine the validity of sentinel node navigation surgery (SNNS) in early stage carcinoma of the tongue, the occurrence rate of postoperative cervical metastasis (POCM) after lead plate technique (LPT) introduction and survival rates in patients who underwent SNNS were analyzed.
Methods: SNNS was performed in 29 patients (stage I: 14, stage II: 15) from 2000 to 2007. Tc-labeled phytate was prepared as a radiotracer a day before SNNS. The sentinel node (SN) was then examined pathologically during surgery. For cases where metastasis in SN was positive, neck dissection was performed. Occurrence of POCM after LPT introduction was compared with that before LPT introduction. 'Wait and see' policy was performed in 52 patients (stage I: 27, stage II: 25) from 1987 to 1999 as a historical control. The observation period of SNNS cases and 'wait and see' policy cases ranged from 10 months to 165 months (median 91 months) and from 7 months to 268 months (median 87 months) respectively.
Results: Six of the 29 SNNS cases (21%) were proven metastatic SNs. Before LPT introduction, POCM occurred in two of the 15 cases, while we had no occurrences after LPT introduction. The 5-year overall survival rate of the 29 patients who underwent SNNS and the 52 patients with 'wait and see' policy were 96% and 84%, respectively, and there was statistical significance in the two groups (p<0.05). Conclusions: As the survival rate of the patients with the SNNS tended to be better than that with the 'wait and see' policy in our cases, SNNS could avoid unnecessary neck dissection. SNNS provides useful information regarding decision making for neck dissection in early stage carcinoma of the tongue.

キーワード

臓器別:頭頸部

手法別:手術療法

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