Sentinel node biopsy using indocyanine green in oral/oropharyngeal cancer

World Journal of Surgical Oncology

Guojun Zhang²  Chongwei Chi¹  Xihong Yang⁵  Xiaohua Niu⁴  Steven J. Wang³  Hanwei Peng⁵ 

[1] Intelligent Medical Research Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China;Breast Cancer Center, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China;Department of Otolaryngology—Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, USA;Current address: Key Lab of Major Obstetrics Disease of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China;Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, No.7 Raoping Road, Shantou City 515031, Guangdong Province, China

关键词: Methylene blue;    Oropharyngeal neoplasms;    Oral neoplasms;    Near-infrared fluorescence;    Indocyanine green;    Sentinel node biopsy;   

Others  :  1225472
DOI  :  10.1186/s12957-015-0691-6

 received in 2015-04-16, accepted in 2015-09-07,  发布年份 2015

【 摘 要 】

Backgrounds

Radioactive tracer-based detection has been proposed as a standard procedure in identifying sentinel nodes for cN0 oral/oropharyngeal carcinoma. However, access to radioactive isotopes may be limited in some surgical centers, and there is potential risk of the radioactive tracers to the operators. This study was designed to evaluate the feasibility of near-infrared fluorescence imaging with indocyanine green combined with blue dye mapping in sentinel node biopsy for cN0 oral/oropharyngeal carcinoma.

Methods

Twenty-six cases of previously untreated oral/oropharyngeal carcinoma staged cT1-2N0M0 were enrolled in this study. One milliliter of indocyanine green (5 mg/ml) and 1.5 ml of methylene blue (1 mg/ml) were injected sequentially around the primary tumor in a four-quadrant pattern before skin incision. After elevation of the platysma flap and posterior retraction of the sternocleidomastoid muscle, fluorescence images were taken with a near-infrared detector, with special attention paid to any blue-dyed lymph nodes. Lymph nodes identified first with fluorescent hot spots with or without blue dye were defined as sentinel nodes, and they were harvested and sent for pathologic study.

Results

Sentinel nodes were successfully harvested in all 26 cases. The number of sentinel nodes (SNs) per case varied from 1 to 9, with an average of 3.4. Routine pathology demonstrated occult metastasis exclusively in SNs in four cases (15.4 %). No tracer-associated side effects occurred in this series.

Conclusions

Near-infrared imaging using indocyanine green combined with methylene blue mapping is a feasible and reliable new method for SN biopsy in cN0 oral/oropharyngeal carcinoma.

【 授权许可】

   
2015 Peng et al.

【 图 表 】

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