Author/Editor		Čižmarevič, Bogdan
Title		Pomen zaščitne bezgavke za izbiro zdravljenja raka ustne votline in srednjega dela žrela
Type		monografija
Place		Ljubljana
Publisher		Univerza v Ljubljani, Medicinska fakulteta
Publication year		2006
Volume		str. 89
Language		slo
Abstract		Introduction .end objectives There is still an ongoing controversy about the optimal treatment of the oral cavity and oropharyngael carcinoma for those patients with whom no sentinel lymph node metastases were clinically detected. Surgical treatment of the primary tumour of the oral cavity and oropharynx often involves an elective dissection of the neck. However, metastases can be expected only in 20% to 40% of the cases. Accordingly about 70% of the patients are operated »unnecessarily«. The objective of this study was to determine whether the number of elective dissections can be reduced by identifying and examinine sentinel lymph nodes by o frozen secrion during operation. Patients and methods The study included 30 previously untreated patients with squamous cell carcinoma of the oral cavity and oropharyux. One patient who had tuberculosis in lymph nodes was excluded from the study. In all cases squamous cell carcinoma was confirmed histologically. Patients with no clinically or with ultrasound detected sentinel lymph node metastases agreed to recommended surgical treatment. On the day prior to surgery all patients underwent a preoperative dynamic and static lymphoscintigraphy with technetium Tc 99-nanocoll. This way we determined the position of one or more sentinel lymph nodes. During surgery the sentinel lymph node was traced with a gamma probe and methylene blue dye and later examined by a pathologist with a frozen section analysis. Irrespective of the results of the frozen section analysis the usual mRND type III dissection was performed. A pathologist later on examined the sentinel lymph node by a serial section, using hematoxylin-eosin (H&E) and immunocxytochemical analysis for cytokeratin. the full pathologic protocol was used to examine all removed lymph nodes. From the obtained results we tried to determine how the status of the sentinel lymph node is reflected in the state of the whole neck. (Abstract truncated at 2000 characters)
Descriptors		MOUTH NEOPLASMS OROPHARYNGEAL NEOPLASMS RADICAL NECK DISSECTION LYMPH NODES CARCINOMA, SQUAMOUS CELL TECHNETIUM METHYLENE BLUE LYMPHATIC METASTASIS PROGNOSIS