Page 76 - Sentinel lymph node biopsy in oral cavity cancer - Inne J. den Toom

Chapter 4 Table 2. Prevalence of ITC, micrometastasis and macrometastasis in positive SLNs Macro 1 (50%) 0 (0%) 3 (33%) 1 (50%) 2 (18%) 15 (44%) 6 (67%) 32 (76%) 9 (24%) 2 (40%) 13 (31%) 16 (44%) 100 (43%) Study All Barzan11 2* Mozillo12 4 Stoeckli13 9 Keski-Säntti14 2 Bilde15 11 Atula16 34 Kovacs17 9 Alkureishi18 42 ** Burcia19 38 Terada20 5 Broglie6 42 Present study 36 Total 234 ITC 0 (0%) 0 (0%) 1 (11%) 0 (0%) 3 (27%) 5 (15%) 0 (0%) 0 (0%) 14 (37%) 0 (0%) 10 (24%) 6 (16%) 39 (17%) Micro 1 (50%) 4 (100%) 5 (56%) 1 (50%) 6 (55%) 14 (41%) 3 (33%) 10 (24%) 15 (39%) 3 (60%) 19 (45%) 14 (39%) 95 (41%) Abbreviations: ITC, isolated tumour cells; micro, micrometastasis; macro, macrometastasis; SLN, sentinel lymph node * only results of cNO early oral cancer ** definition of micrometastasis: only detected by step serial sectioning and/or immunohistochemistry In none of the SLNs with ITC based on size, extravasation, extravascular stromal reaction or extravascular tumour cell proliferation were found, but all these SLNs had contact with lymph sinus wall. In 6/36 (17%) patients who underwent a subsequent neck dissection additional lymph node metastases were found. All patients had T2 tumours and the SLN had contained a macrometastasis (Table 3). Additional non-SLN metastases were found in level I (n=3), level III (n=6), level IV (n=1) and level V (n=1). In 1 patient non-SLN metastasis was restricted to the same level as the positive SLN, in 1 patient in adjacent and nonadjacent levels and in 4 patients non- SLN metastasis were only found in nonadjacent levels. 74