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Metastatic lymph nodes in the neck of patients with T1 and T2 squamous cell carcinoma of the lower lip detected with lymphoscintigraphy

Aims and background The aim of our research was to use lymphoscintigraphy as a main method to confirm and detect lymph nodes in the neck, in patients with squamos cell carcinoma of lower lip which were clinically T1, T2 and N0, and to justify the use of selective neck dissection in those patients.

Methods From April 2010 to January 2011, 31 patients with T1, T2 and N0 SCC of the lower lip were admitted to our center. To detect sentinel lymph nodes, we performed lymphoscintigraphy (LSG). LSG was performed on the day of surgery after intradermal injection of 37 Mbq of Tc99m-Sn-colloid/ml at four peritumoral sites. The sentinel lymph nodes were then extirpated and sent for biopsy.

Results Among the 31 patients, three (9.7%) were female and 28 (90.3%) were male. LSG detected sentinel nodes in the neck in 21 (67.7%) of the patients. Of these, 10 (47.6%) had a positive sentinel node biopsy. Of all 31 patients enrolled in the study, occult metastases were found in 10 (32.3%). Conclusions Our results indicate that, of the methods used to detect positive lymph nodes, the most accurate is LSG. The results also suggest that further study is needed to optimize the treatment protocol in patients with SCC of the lower lip, especially in those with T2 lesions.

Author(s): Mergime Prekazi Loxha, Idriz Gerqari , Sami Salihu, Zana Agani, Vjosa Hamiti