Sentinel node
- 1. SENTINEL NODE PREPARED BY-DR DHWANI RANVERIA
- 2. • The first node reached by the lymphatic stream, assuming an orderly and sequential drainage from the tumour site, • And should be predictive of the nodal stage. L. Calabrese Et Al. Sentinel Node In Oral Cancer Acta Otorhinolaryngol Ital 26, 345- 349, 2006
- 3. • If the Sentinel Node is free from cancer cells, • Then distal node involvement is assumed to be rare. • Alvarez et al.Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinoma Med Oral Patol Oral Cir Bucal 2007; 12:E235–43.
- 4. Flowchart Depicting The Process Of Primary Tumour Spread To A Sentinel Lymph Node. Sharma et al., Sentinel Lymph Node Biopsy, Sultan Qaboos University Med J, February 2017, Vol. 17, Iss. 1, pp. e3–10
- 5. • Recently, the concept of a sentinel lymph node (SLN) was introduced in head and neck squamous cell carcinomas (HNSCCs) • In order to more precisely detect and evaluate neck metastasis and unpredictable lymphatic drainage patterns, following its successful application in melanomas and breast cancer. . • Sharma et al., Sentinel Lymph Node Biopsy, Sultan Qaboos University Med J, February 2017, Vol. 17, Iss. 1, pp. e3–10
- 6. The Techniques And Methodology For SLN Identification • Shoaib et al. suggested a protocol involving 1. preoperative lymphoscintigraphy, 2. intraoperative blue dye and 3. gamma probe localization. Shoaib T, et al. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer 2001
- 7. The Techniques And Methodology For SLN Identification 1. Lymphoscintigraphy reveals SLNs associated with the primary tumour, 2. To enhance the detection rate, blue dye is often used in combination with radioisotopes. 3. During the surgery, a handheld gamma probe is used for radionuclide detection to trace the SLN perioperatively and a gamma camera is used for dynamic monitoring of lymphatic drainage.
- 8. Sentinel Node Biopsy • Diagnostic technique used to assess the presence of occult metastatic disease in the N0 neck. • In 1996, the first successful SLN Biopsy was performed by Alex et al. on a patient with a laryngeal supraglottic carcinoma. • Rakheja M et al Sentinel lymph node biopsy in oral squamous cell carcinoma: Ensuing from elective to selective. J Res Med Dent Sci 2014; 2:5–10.
- 9. Proposed treatment protocol for a sentinel lymph node biopsy. Shoaib T, et al. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer 2001
- 10. Sentinel European Node Trial (SENT): 3-year Results Of Sentinel Node Biopsy In Oral Cancer C. Schilling et al. / European Journal of Cancer 51 (2015)
- 12. CONCLUSION • Not a widely used diagnostic adjunct in N0 neck • It does hold the potential to be used as single diagnostic modality in determining the management of early N0 lesions • It is an accurate and oncologically safe procedure. C. Schilling et al. / European Journal of Cancer 51 (2015)
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