1
|
Does sentinel lymph node biopsy accurately stage the clinically negative neck in early oral cavity squamous cell carcinoma? J Oral Maxillofac Surg 2022; 80:1134-1142. [DOI: 10.1016/j.joms.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/21/2022]
|
2
|
Muhanna N, Chan HHL, Douglas CM, Daly MJ, Jaidka A, Eu D, Bernstein J, Townson JL, Irish JC. Sentinel lymph node mapping using ICG fluorescence and cone beam CT - a feasibility study in a rabbit model of oral cancer. BMC Med Imaging 2020; 20:106. [PMID: 32928138 PMCID: PMC7491106 DOI: 10.1186/s12880-020-00507-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 09/07/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Current sentinel lymph node biopsy (SLNB) techniques, including use of radioisotopes, have disadvantages including the use of a radioactive tracer. Indocyanine green (ICG) based near-infrared (NIR) fluorescence imaging and cone beam CT (CBCT) have advantages for intraoperative use. However, limited literature exists regarding their use in head and neck cancer SLNB. METHODS This was a prospective, non-randomized study using a rabbit oral cavity VX2 squamous cell carcinoma model (n = 10) which develops lymph node metastasis. Pre-operatively, images were acquired by MicroCT. During surgery, CBCT and NIR fluorescence imaging of ICG was used to map and guide the SLNB resection. RESULTS Intraoperative use of ICG to guide fluorescence resection resulted in identification of all lymph nodes identified by pre-operative CT. CBCT was useful for near real time intraoperative imaging and 3D reconstruction. CONCLUSIONS This pre-clinical study further demonstrates the technical feasibility, limitations and advantages of intraoperative NIR-guided ICG imaging for SLN identification as a complementary method during head and neck surgery.
Collapse
Affiliation(s)
- Nidal Muhanna
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Harley H L Chan
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada
| | - Catriona M Douglas
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada.
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada.
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
| | - Michael J Daly
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada
| | - Atul Jaidka
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada
| | - Donovan Eu
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada
| | - Jonathan Bernstein
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jason L Townson
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada
| | - Jonathan C Irish
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| |
Collapse
|
3
|
Dai W, Li Y, Wu Z, Feng Y, Cai S, Xu Y, Li Q, Cai G. Pathological nodal staging score for rectal cancer patients treated with radical surgery with or without neoadjuvant therapy: a postoperative decision tool. Cancer Manag Res 2019; 11:537-546. [PMID: 30662284 PMCID: PMC6327887 DOI: 10.2147/cmar.s169309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Lymph node status can predict the prognosis of patients with rectal cancer treated with surgery. Thus, we sought to establish a standard for the minimum number of lymph nodes (LNs) examined in patients with rectal cancer by evaluating the probability that pathologically negative LNs prove positive during surgery. Patients and methods We extracted information of 31,853 patients with stage I–III rectal carcinoma registered between 2004 and 2013 from the Surveillance, Epidemiology, and End Results database and divided them into two groups: the first group was SURG, including patients receiving surgery directly and the other group was NEO, encompassing those underwent neo-adjuvant therapy. Using a beta-binomial model, we developed nodal staging score (NSS) based on pT/ypT stage and the number of LNs retrieved. Results In both cohorts, the false-negative rate was estimated to be 16% when 12 LNs were examined, but it dropped to 10% when 20 LNs were evaluated. In the SURG cohort, to rule out 90% possibility of false staging, 3, 7, 28, and 32 LNs would be necessarily examined in patients with pT1–4 disease, respectively. While in the NEO cohort, 4, 7, 12, and 16 LNs would be included for examination in patients with ypT1–4 disease to guarantee an NSS of 90%. Conclusion By determining whether a rectal cancer patient with negative LNs was appropriately staged, the NSS model we developed in this study may assist in tailoring postoperative management.
Collapse
Affiliation(s)
- Weixing Dai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China, , .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China, ,
| | - Yaqi Li
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China, , .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China, ,
| | - Zhenyu Wu
- Department of Biostatistics, School of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China
| | - Yang Feng
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China, , .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China, ,
| | - Sanjun Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China, , .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China, ,
| | - Ye Xu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China, , .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China, ,
| | - Qingguo Li
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China, , .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China, ,
| | - Guoxiang Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China, , .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China, ,
| |
Collapse
|
4
|
Maruyama T, Nishihara K, Saio M, Nakasone T, Nimura F, Matayoshi A, Goto T, Yoshimi N, Arasaki A. Kikuchi-Fujimoto disease in the regional lymph nodes with node metastasis in a patient with tongue cancer: A case report and literature review. Oncol Lett 2017; 14:257-263. [PMID: 28693162 PMCID: PMC5494837 DOI: 10.3892/ol.2017.6139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 03/09/2017] [Indexed: 02/05/2023] Open
Abstract
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare self-limiting disorder typically affecting the cervical lymph nodes (LNs), which is often misdiagnosed as other LN-associated diseases. KFD frequently presents with necrotic lesions and recurrences, which are also features of metastatic LNs. Clinicians may thus suspect LN metastasis when they encounter ipsilateral cervical lymphadenopathy in a patient with head and neck cancer. The present study reports the case of a 48-year-old man with tongue cancer and KFD affecting the right edge of his tongue and ipsilateral cervical LNs. LN metastasis was initially suspected, but pathological examination of the dissected LNs revealed one necrotic metastatic lesion and two necrotic KFD lesions. Ipsilateral cervical lymphadenopathy recurred 6 years after the initial surgery, and it was not possible to differentiate clinically between a second primary tumor and recurrent KFD prior to treatment. To the best of our knowledge, this is the first reported case of simultaneous tongue cancer, regional LN metastasis and KFD. This highlights the requirement to consider KFD in the event of LNs with necrotic lesions but no cancerous cells. A combination of clinical and pathological approaches may aid in the diagnosis of KFD, in addition to ruling out LN metastasis in initial and recurrent lymphadenopathies. The present study indicate that a diagnosis of KFD should be considered in patients with head and neck cancer that exhibit necrotic LNs lacking cancerous cells. This is important, as misdiagnosis of KFD as LN metastasis may lead to unnecessary adjuvant therapy.
Collapse
Affiliation(s)
- Tessho Maruyama
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, Ryukyu University Hospital, Nishihara, Okinawa 903-0215, Japan
| | - Kazuhide Nishihara
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, Ryukyu University Hospital, Nishihara, Okinawa 903-0215, Japan
| | - Masanao Saio
- Department of Pathology, Ryukyu University Hospital, Nishihara, Okinawa 903-0215, Japan
- Department of Pathology and Oncology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Toshiyuki Nakasone
- Department of Oral and Maxillofacial Surgery, Ryukyu University Hospital, Nishihara, Okinawa 903-0215, Japan
| | - Fumikazu Nimura
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
| | - Akira Matayoshi
- Department of Oral and Maxillofacial Surgery, Ryukyu University Hospital, Nishihara, Okinawa 903-0215, Japan
| | - Takahiro Goto
- Department of Oral and Maxillofacial Surgery, Ryukyu University Hospital, Nishihara, Okinawa 903-0215, Japan
| | - Naoki Yoshimi
- Department of Pathology, Ryukyu University Hospital, Nishihara, Okinawa 903-0215, Japan
| | - Akira Arasaki
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan
- Department of Oral and Maxillofacial Surgery, Ryukyu University Hospital, Nishihara, Okinawa 903-0215, Japan
| |
Collapse
|
5
|
Abdul-Razak M, Chung H, Wong E, Palme C, Veness M, Farlow D, Coleman H, Morgan G. Sentinel lymph node biopsy for early oral cancers: Westmead Hospital experience. ANZ J Surg 2016; 87:65-69. [PMID: 27878928 DOI: 10.1111/ans.13853] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 06/23/2016] [Accepted: 10/18/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sentinel lymph node biopsy (SLNB) has become an alternative option to elective neck dissection (END) for early oral cavity squamous cell carcinoma (OCSCC) outside of Australia. We sought to assess the technical feasibility of SLNB and validate its accuracy against that of END in an Australian setting. METHODS We performed a prospective cohort study consisting of 30 consecutive patients with cT1-2 N0 OCSCC referred to the Head and Neck Cancer Service, Westmead Hospital, Sydney, between 2011 and 2014. All patients underwent SLNB followed by immediate selective neck dissection (levels I-III). RESULTS A total of 30 patients were diagnosed with an early clinically node-negative OCSCC (seven cT1 and 23 cT2), with the majority located on the oral tongue. A median of three (range: 1-14) sentinel nodes were identified on lymphoscintigraphy, and all sentinel nodes were successfully retrieved, with 50% having a pathologically positive sentinel node. No false-negative sentinel nodes were identified using selective neck dissection as the gold standard. The negative predictive value (NPV) of SLNB was 100%, with 40% having a sentinel node identified outside the field of planned neck dissection on lymphoscintigraphy. Of these, one patient had a positive sentinel node outside of the ipsilateral supraomohyoid neck dissection template. CONCLUSION SLNB for early OCSCC is technically feasible in an Australian setting. It has a high NPV and can potentially identify at-risk lymphatic basins outside the traditional selective neck dissection levels even in well-lateralized lesions.
Collapse
Affiliation(s)
- Muzib Abdul-Razak
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Hsiang Chung
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia
| | - Eva Wong
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia
| | - Carsten Palme
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia.,Sydney Head and Neck Institute, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Michael Veness
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - David Farlow
- Department of Nuclear Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - Hedley Coleman
- Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, New South Wales, Australia
| | - Gary Morgan
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|