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The value of frozen section analysis of the sentinel lymph node in clinically N0 squamous cell carcinoma of the oral cavity and oropharynx.
Otolaryngol Head Neck Surg. 2005 Jan; 132(1):99-102.OH

Abstract

OBJECTIVE

To determine the feasibility and accuracy of fine-sectioned frozen-section analysis of the sentinel lymph node (SLN) in cN0 oral cavity and oropharynx squamous cell carcinoma.

STUDY DESIGN

Thirty-one patients were included and underwent lymphoscintigraphy a day before surgery and marking of the SLN. Intraoperatively, the SLNs were identified using a gamma probe, excised, and analyzed using fine-sectioned frozen section. The remaining SLN tissue was fixed in formalin for further staining and immunohistochemical analysis. An elective neck dissection was performed in all patients and all excised lymph nodes were examined for metastatic disease.

RESULTS

SLNs were identified preoperatively by lymphoscintigraphy as well as by gamma probe intraoperatively in all patients. A total of 82 sentinel lymph nodes were excised and analyzed by fine-sectioned frozen section. Micrometastases were found in 16 out of the 82 SLNs, upstaging 14 out of 31 patients (45%) from cN0 to pN+. Furthermore, a total of 1295 lymph nodes from the neck dissection specimens were analyzed, confirming only one more metastatic disease. Sensitivity and negative predictive value of SLN biopsy were 93% and 94% respectively for frozen section analysis.

CONCLUSION

Our study shows that SLN biopsy in cN0 neck of patients with oral cavity and oropharyngeal carcinoma is both feasible and accurate. Provided that larger studies confirm our results, an elective neck dissection may become unnecessary if fine-sectioned frozen-section analysis of the SLN shows no nodal metastases in patients with cN0 oral cavity and oropharynx carcinoma.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, University Hospital Bern, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15632917

Citation

Tschopp, Laurent, et al. "The Value of Frozen Section Analysis of the Sentinel Lymph Node in Clinically N0 Squamous Cell Carcinoma of the Oral Cavity and Oropharynx." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 132, no. 1, 2005, pp. 99-102.
Tschopp L, Nuyens M, Stauffer E, et al. The value of frozen section analysis of the sentinel lymph node in clinically N0 squamous cell carcinoma of the oral cavity and oropharynx. Otolaryngol Head Neck Surg. 2005;132(1):99-102.
Tschopp, L., Nuyens, M., Stauffer, E., Krause, T., & Zbären, P. (2005). The value of frozen section analysis of the sentinel lymph node in clinically N0 squamous cell carcinoma of the oral cavity and oropharynx. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 132(1), 99-102.
Tschopp L, et al. The Value of Frozen Section Analysis of the Sentinel Lymph Node in Clinically N0 Squamous Cell Carcinoma of the Oral Cavity and Oropharynx. Otolaryngol Head Neck Surg. 2005;132(1):99-102. PubMed PMID: 15632917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The value of frozen section analysis of the sentinel lymph node in clinically N0 squamous cell carcinoma of the oral cavity and oropharynx. AU - Tschopp,Laurent, AU - Nuyens,Michel, AU - Stauffer,Edouard, AU - Krause,Thomas, AU - Zbären,Peter, PY - 2005/1/6/pubmed PY - 2005/2/23/medline PY - 2005/1/6/entrez SP - 99 EP - 102 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 132 IS - 1 N2 - OBJECTIVE: To determine the feasibility and accuracy of fine-sectioned frozen-section analysis of the sentinel lymph node (SLN) in cN0 oral cavity and oropharynx squamous cell carcinoma. STUDY DESIGN: Thirty-one patients were included and underwent lymphoscintigraphy a day before surgery and marking of the SLN. Intraoperatively, the SLNs were identified using a gamma probe, excised, and analyzed using fine-sectioned frozen section. The remaining SLN tissue was fixed in formalin for further staining and immunohistochemical analysis. An elective neck dissection was performed in all patients and all excised lymph nodes were examined for metastatic disease. RESULTS: SLNs were identified preoperatively by lymphoscintigraphy as well as by gamma probe intraoperatively in all patients. A total of 82 sentinel lymph nodes were excised and analyzed by fine-sectioned frozen section. Micrometastases were found in 16 out of the 82 SLNs, upstaging 14 out of 31 patients (45%) from cN0 to pN+. Furthermore, a total of 1295 lymph nodes from the neck dissection specimens were analyzed, confirming only one more metastatic disease. Sensitivity and negative predictive value of SLN biopsy were 93% and 94% respectively for frozen section analysis. CONCLUSION: Our study shows that SLN biopsy in cN0 neck of patients with oral cavity and oropharyngeal carcinoma is both feasible and accurate. Provided that larger studies confirm our results, an elective neck dissection may become unnecessary if fine-sectioned frozen-section analysis of the SLN shows no nodal metastases in patients with cN0 oral cavity and oropharynx carcinoma. SN - 0194-5998 UR - https://www.unboundmedicine.com/medline/citation/15632917/The_value_of_frozen_section_analysis_of_the_sentinel_lymph_node_in_clinically_N0_squamous_cell_carcinoma_of_the_oral_cavity_and_oropharynx_ L2 - http://journals.sagepub.com/doi/full/10.1016/j.otohns.2004.09.010?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -