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HNO. 2001 Aug;49(8):646-53.

[Sentinel lymph node excision. Treatment method of the N0 neck in patients with oral and oropharyngeal carcinoma].

[Article in German]

Author information

  • 1Klinik und Poliklinik für Kiefer- und Plastische Gesichtschirurgie, Johann Wolfgang Goethe-Universität Frankfurt am Main. A.Kovacs@em.uni-frankfurt.de



The clinically non-metastatic neck is an unsolved problem in the treatment of oral and oropharyngeal squamous cell carcinomas. A rational procedure is looked for which is neither exaggerated nor neglects the needed safety.


15 patients with primary squamous cell carcinomas of the oral cavity and the oropharynx, staging T1-4N0M0 were examined. After peritumoral intramucodermal injection of tc99m-labeled colloidal albumin the lymphoscintigraphy using gamma-camera imaging prior and hand-held gamma-probe during operation were used for identification of the nodes. Selective sentinel lymph node exstirpation was followed by radical tumor resection.


In all cases (n = 41) lymph nodes could be detected, 40 of them were sentinel lymph nodes, distributed to all neck levels, in 5 cases bilateral drainage. 92.5% of sentinel lymph nodes could be actually removed. All but 1 (97.5%) were true-negative. In the positive case modified radical neck dissection harvested another affected node.


Methodically seen, the sentinel procedure works well and might lead to reduced post-surgical morbidity in about 50% of patients with oral cancer. To date, the procedure should be confined to studies with special requirements to diagnostics and subsequent treatment.

[PubMed - indexed for MEDLINE]
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