TY - JOUR
T1 - Lymphatic drainage patterns in oral squamous cell carcinoma
T2 - Findings of the ACOSOG Z0360 (Alliance) study
AU - Farmer, Roger W.
AU - McCall, Linda
AU - Civantos, Francisco J.
AU - Myers, Jeffrey N.
AU - Yarbrough, Wendell G.
AU - Murphy, Barbara
AU - O'Leary, Miriam
AU - Zitsch, Robert
AU - Siegel, Barry A.
N1 - Funding Information:
Funding source: The research for ACOSOG Z0360 (Alliance) was supported, in part, by grants from the National Cancer Institute (CA076001) to the American College of Surgeons Oncology Group, (CA31946) to the Alliance for Clinical Trials in Oncology (Monica M. Bertagnolli, MD, Chair) and to the Alliance Statistics and Data Center (Daniel J. Sargent, PhD, CA33601). Collection, analysis, and interpretation of data.
Funding Information:
Competing interests: Wendell G. Yarbrough, Plexxion, AbbVie, grant funding; Robert Zitsch, The University of Missouri received financial support from ACOSOG on behalf of efforts of Robert Zitsch as investigator for the ACOSOG Z0360 study.
Publisher Copyright:
© American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015. .
PY - 2015/4/7
Y1 - 2015/4/7
N2 - Objective. The purpose of our study was to correlate sentinel lymph nodes (SLN) found on planar lymphoscintigraphy (LS) to SLN found with gamma probe-directed sentinel lymph node biopsy (SLNB) for T1/T2 N0 oral cavity cancer. Study Design. Prospective cooperative group trial. Setting. Academic medical centers. Subjects and Methods. One hundred forty adults with untreated T1/T2 N0 squamous cell carcinoma (SCC) of the oral cavity underwent planar LS, resection, SLNB, and neck dissection. Location of SLN by planar LS and SLNB and of metastases were compared to each other and historical data of regional metastases. Results. SLNs located by planar LS and SLNB were predominantly in levels I through IV. There was heterogeneity in the number of SLNs found at planar LS and at SLNB, which was significantly different in levels II and III (P<.0001). In 14 of 33 cases with bilateral drainage on planar LS, SLNB detected only unilateral SLN. Sensitivity of planar LS in predicting the level of SLN was 41% to 63%, and specificity was 68% to 95%. Comparison of locations of the metastases to historical data showed fewer metastases to level I in our study (P = .03). Metastases occurred predominantly in levels I through III. In 1 case of a lateral tongue cancer, a contralateral SLN was the only positive node. Conclusion. Lymphatic drainage patterns and metastases involved predominantly levels I through III.
AB - Objective. The purpose of our study was to correlate sentinel lymph nodes (SLN) found on planar lymphoscintigraphy (LS) to SLN found with gamma probe-directed sentinel lymph node biopsy (SLNB) for T1/T2 N0 oral cavity cancer. Study Design. Prospective cooperative group trial. Setting. Academic medical centers. Subjects and Methods. One hundred forty adults with untreated T1/T2 N0 squamous cell carcinoma (SCC) of the oral cavity underwent planar LS, resection, SLNB, and neck dissection. Location of SLN by planar LS and SLNB and of metastases were compared to each other and historical data of regional metastases. Results. SLNs located by planar LS and SLNB were predominantly in levels I through IV. There was heterogeneity in the number of SLNs found at planar LS and at SLNB, which was significantly different in levels II and III (P<.0001). In 14 of 33 cases with bilateral drainage on planar LS, SLNB detected only unilateral SLN. Sensitivity of planar LS in predicting the level of SLN was 41% to 63%, and specificity was 68% to 95%. Comparison of locations of the metastases to historical data showed fewer metastases to level I in our study (P = .03). Metastases occurred predominantly in levels I through III. In 1 case of a lateral tongue cancer, a contralateral SLN was the only positive node. Conclusion. Lymphatic drainage patterns and metastases involved predominantly levels I through III.
KW - lymphoscintigraphy
KW - oral squamous cell carcinoma
KW - sentinel lymph node
UR - http://www.scopus.com/inward/record.url?scp=84926382450&partnerID=8YFLogxK
U2 - 10.1177/0194599815572585
DO - 10.1177/0194599815572585
M3 - Article
C2 - 25749001
AN - SCOPUS:84926382450
SN - 0194-5998
VL - 152
SP - 673
EP - 677
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 4
ER -