Identification of occult metastatic disease via lymphoscintigraphy-guided neck dissection in N0 oral squamous cell carcinoma

Head Neck. 2022 Jul;44(7):1596-1603. doi: 10.1002/hed.27059. Epub 2022 Apr 16.

Abstract

Background: The purpose of this study is to assess the efficacy of lymphoscintigraphy-guided neck dissection (LSG-ND) in the treatment of N0 oral squamous cell carcinoma.

Methods: A retrospective cohort study of patients with N0 oral squamous cell carcinoma (SCC) who had either LSG-ND or neck dissection (ND) at our institution between 2008 and 2020.

Results: Eighty-seven patients met criteria with N0 oral squamous cell carcinoma with no previous treatment or neck surgery (27 LSG-ND, 60 ND). Sentinel lymph nodes were identified on the contralateral side in 14.8% of patients with unilateral tumors in the LSG-ND group, with 22.2% of cases with unexpected lymphatic drainage outside ipsilateral levels I-III. No recurrences to date have occurred in the LSG-ND cohort, while 13.3% of patients with ND had regional recurrence (p = 0.04).

Conclusions: LSG-ND provides a greater ability to identify occult metastatic disease with a significant reduction in regional recurrence in N0 oral SCC.

Keywords: N0 oral SCC; lymphoscintigraphy; metastasis; oral squamous cell carcinoma; regional recurrence.

MeSH terms

  • Carcinoma, Squamous Cell* / diagnostic imaging
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Lymphoscintigraphy
  • Mouth Neoplasms* / diagnostic imaging
  • Mouth Neoplasms* / pathology
  • Mouth Neoplasms* / surgery
  • Neck Dissection
  • Neoplasm Staging
  • Neoplasms, Second Primary* / pathology
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy
  • Squamous Cell Carcinoma of Head and Neck / diagnostic imaging
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / surgery