Skip to main content
SpringerLink
Log in

Head and neck cancer: towards a new paradigm with sentinel node localization

  • Review Article
  • Published:
Clinical and Translational Imaging Aims and scope Submit manuscript

Abstract

In an attempt to improve the detection of occult lymph node metastasis and avoid the morbidity, burden and costs of unnecessary elective neck dissection, sentinel node biopsy has been introduced successfully in early oral cancer: a sensitivity of 93 % and negative predictive values of 80–100 % have been reported. In comparison with elective neck dissection (in all patients), sentinel node biopsy (with neck dissection only in if sentinel node is positive) is associated with less complications, less shoulder morbidity and lower costs. In case of a positive sentinel node, neck dissections can potentially be tailored to the individual patient. Results in other non-cutaneous head and neck sites are promising, but need further research before entering routine clinical practice. New developments in tracers and instruments may increase the sensitivity of sentinel node biopsy further and facilitate harvesting of sentinel nodes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ferlay J, Shin HR, Bray F et al (2010) Estimates of worldwide burden of cancer in 2008; GLOBOCAN 2008. Int J Cancer 127:2893–2917

    Article  CAS  PubMed  Google Scholar 

  2. Leusink FK, van Es RJ, de Bree R et al (2012) Novel diagnostic modalities for assessment of the clinically node-negative neck in oral squamous-cell carcinoma. Lancet Oncol 13(12):E554–E561

    Article  PubMed  Google Scholar 

  3. De Bree R, Takes RP, Castelijns JA et al (2014) Advances in diagnostic modalities to detect occult lymph node metastases in head and neck squamous cell carcinoma. Head Neck. doi:10.1002/hed.23814 (Epub ahead of print)

    Google Scholar 

  4. Liao LJ, Lo WC, Hsu WL, Wang CT, Lai MS (2012) Detection of cervical lymph node metastasis in head and neck cancer patients with clinically N0 neck-a meta-analysis comparing different imaging modalities. BMC Cancer 12:236

    Article  PubMed Central  PubMed  Google Scholar 

  5. Van Wouwe M, de Bree R, Kuik DJ et al (2009) Shoulder morbidity after non-surgical treatment of the neck. Radiother Oncol 90:196–201

    Article  PubMed  Google Scholar 

  6. Alkureishi LW, Burak Z, Alvarez JA et al (2009) Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging 36:1915–1936

    Article  PubMed Central  PubMed  Google Scholar 

  7. Heuveling DA, Flach GB, van Schie A et al (2012) Visualization of the sentinel node in early-stage oral cancer: limited value of late static lymphoscintigraphy. Nucl Med Commun 33:1065–1069

    Article  PubMed  Google Scholar 

  8. Leong SP, Kim J, Ross M et al (2011) A phase 2 study of (99m)Tc-tilmanocept in the detection of sentinel lymph nodes in melanoma and breast cancer. Ann Surg Oncol 18:961–969

    Article  PubMed Central  PubMed  Google Scholar 

  9. Marcinow AM, Hall N, Byrum E, Teknos TN, Old MO, Agrawal A (2013) Use of a novel receptor-targeted (CD206) radiotracer, 99mTc-tilmanocept, and SPECT/CT for sentinel lymph node detection in oral cavity squamous cell carcinoma: initial institutional report in an ongoing phase 3 study. JAMA Otolaryngol Head Neck Surg 139:895–902

    Article  PubMed Central  PubMed  Google Scholar 

  10. Paleri V, Rees G, Arullendran P, Shoaib T, Krishman S (2005) Sentinel node biopsy in squamous cell cancer of the oral cavity and oral pharynx: a diagnostic meta-analysis. Head Neck 27:739–747

    Article  PubMed  Google Scholar 

  11. Civantos FJ, Zitsch RP, Schuller DE et al (2010) Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol 28:1395–1400

    Article  PubMed Central  PubMed  Google Scholar 

  12. Thompson CF, John MA, Lawson G, Grogan T, Elashoff D, Mendelsohn AH (2013) Diagnostic value of sentinel lymph node biopsy in head and neck cancer: a meta-analysis. Eur Arch Otorhinolaryngol 270:2115–2122

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Rinaldo A, Devaney KO, Ferlito A (2004) Immunohistochemical studies in the identification of lymph node micrometastases in patients with squamous cell carcinoma of the head and neck. ORL J Otorhinolaryngol Relat Spec 66:38–41

    Article  PubMed  Google Scholar 

  14. De Bree R (2013) How to analyze the diagnostic value of sentinel node biopsy in head and neck cancer. Eur Arch Otorhinolaryngol 270:789–791

    Article  PubMed  Google Scholar 

  15. Alkureishi LW, Ross GL, Shoaib T et al (2010) Sentinel node biopsy in head and neck squamous cell cancer: 5-year follow-up of a European multicenter trial. Ann Surg Oncol 17:2459–2464

    Article  PubMed  Google Scholar 

  16. Kovacs AF, Stefenelli U, Seitz O et al (2009) Positive sentinel lymph nodes are a negative prognostic factor for survival in T1-2 oral/oropharyngeal cancer-a long-term study on 103 patients. Ann Surg Oncol 16:233–239

    Article  PubMed  Google Scholar 

  17. Broglie MA, Haile SR, Stoeckli SJ (2011) Long-term experience in sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma. Ann Surg Oncol 18:2732–2738

    Article  PubMed  Google Scholar 

  18. Den Toom IJ, Heuveling DA, Flach GB et al (2014) Sentinel node biopsy for early oral cavity cancer: the VU University Medical Center experience. Head Neck. doi:10.1002/hed.23632 (Epub ahead of print)

    Google Scholar 

  19. Govers TM, Hannink G, Merkx MA, Takes RP, Rovers MM (2013) Sentinel node biopsy for squamous cell carcinoma of the oral cavity and oropharynx: a diagnostic meta-analysis. Oral Oncol 49:726–732

    Article  PubMed  Google Scholar 

  20. Flach GB, Bloemena E, Klop WM et al (2014) Sentinel lymph node biopsy in clinically N0 T1-T2 staged oral cancer: The Dutch multicenter trial. Oral Oncol 50:1020–1024

    Article  PubMed  Google Scholar 

  21. Ross GL, Shoaib T, Soutar DS (2002) The first international conference on sentinel node biopsy in mucosal head and neck cancer and adoption of a multicenter trial protocol. Ann Surg Oncol 9:406–410

    Article  CAS  PubMed  Google Scholar 

  22. Ross GL, Soutar DS, MacDonald G et al (2004) Sentinel node biopsy in head and neck cancer: preliminary results of a multicenter trial. Ann Surg Oncol 11:690–696

    Article  PubMed  Google Scholar 

  23. Flach GB, Broglie MA, van Schie A et al (2012) Sentinel node biopsy for oral and oropharyngeal squamous cell carcinoma in the previously treated neck. Oral Oncol 48:85–89

    Article  PubMed  Google Scholar 

  24. Gurney BA, Schilling C, Putcha V et al (2012) Implications of a positive sentinel node in oral squamous cell carcinoma. Head Neck 34:1580–1585

    Article  PubMed  Google Scholar 

  25. Murer K, Huber GF, Haile SR, Stoeckli SJ (2011) Comparison of morbidity between sentinel node biopsy and elective neck dissection for treatment of the n0 neck in patients with oral squamous cell carcinoma. Head Neck 33:1260–1264

    Article  PubMed  Google Scholar 

  26. Schiefke F, Akdemir M, Weber A, Akdemir D, Singer S, Frerich B (2009) Function, postoperative morbidity, and quality of life after cervical sentinel node biopsy and after selective neck dissection. Head Neck 31:503–512

    Article  PubMed  Google Scholar 

  27. O’Connor R, Pezier T, Schilling C, McGurk M (2013) The relative cost of sentinel lymph node biopsy in early oral cancer. J Craniomaxillofac Surg 41:721–727

    Article  PubMed  Google Scholar 

  28. Kosuda S, Kusano S, Kohno N et al (2003) Feasibility and cost-effectiveness of sentinel lymph node radio-localization in stage N0 head and neck cancer. Arch Otolaryngol Head Neck Surg 129:1105–1109

    Article  PubMed  Google Scholar 

  29. Govers TM, Takes RP, Karakullukcu BM et al (2013) Management of the N0 neck in early stage oral squamous cell cancer: a modeling study of the cost-effectiveness. Oral Oncol 49:771–777

    Article  PubMed  Google Scholar 

  30. www.nccn.org (2 December 2014)

  31. Haerle SK, Hany TF, Strobel K, Sidler D, Stoeckli SJ (2009) Is there an additional value of SPECT/CT over planar lymphoscintigraphy for sentinel node mapping in oral/oropharyngeal squamous cell carcinoma? Ann Surg Oncol 16:3118–3124

    Article  PubMed  Google Scholar 

  32. Heuveling DA, van Schie A, Vugts DJ et al (2013) Pilot study on the feasibility of PET/CT lymphoscintigraphy with 89Zr-nanocolloidal albumin for sentinel node identification in oral cancer patients. J Nucl Med 54:585–589

    Article  CAS  PubMed  Google Scholar 

  33. Vermeeren L, Valdés Olmos RA, Klop WM, Balm AJ, van den Brekel MW (2010) A portable gamma-camera for intraoperative detection of sentinel nodes in the head and neck region. J Nucl Med 51:700–703

    Article  PubMed  Google Scholar 

  34. Heuveling DA, Karagozoglu KH, van Schie A, van Weert S, van Lingen A, de Bree R (2012) Sentinel node biopsy using 3D lymphatic mapping by freehand SPECT in early stage oral cancer: a new technique. Clin Otolaryngol 37:89–90

    Article  CAS  PubMed  Google Scholar 

  35. Bluemel C, Herrmann K, Kübler A, et al (2014) Intraoperative 3-D imaging improves sentinel lymph node biopsy in oral cancer. Eur J Nucl Med Mol Imaging (Epub ahead of print)

  36. van den Berg NS, Brouwer OR, Klop WM et al (2012) Concomitant radio- and fluorescence-guided sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity using ICG-(99m)Tc-nanocolloid. Eur J Nucl Med Mol Imaging 39:1128–1136

    Article  CAS  PubMed  Google Scholar 

  37. Heuveling DA, Visser GWM, De Groot M et al (2012) Nanocolloidal albumin-IRDye 800CW: a near-infrared fluorescent tracer with optimal retention in the sentinel lymph node. Eur J Nucl Med Mol Imaging 39:1161–1168

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Flach GB, Bloemena E, van Schie A et al (2013) Sentinel node identification in laryngeal cancer: feasible in primary cancer with previously untreated neck. Oral Oncol 49:165–168

    Article  PubMed  Google Scholar 

  39. Schilling C, Gnanasegaran G, McGurk M (2014) Three-dimensional imaging and navigated sentinel node biopsy for primary parotid malignancy: new application in parotid cancer management. Head Neck 36:E91–E93

    PubMed  Google Scholar 

Download references

Conflict of interest

Remco de Bree declares no conflict of interest.

Human and animal studies

This article does not contain any studies with human or animal subjects performed by the author, besides studies which are reviewed, described and referred to in the reference list.

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, PO Box 7057, 1007, MB, Amsterdam, The Netherlands

    Remco de Bree

Authors
  1. Remco de Bree
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Remco de Bree.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Bree, R. Head and neck cancer: towards a new paradigm with sentinel node localization. Clin Transl Imaging 3, 195–202 (2015). https://doi.org/10.1007/s40336-014-0096-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40336-014-0096-5

Keywords

Search

Navigation