Estudio preliminar del ganglio centinela en el cáncer oral: a propósito de 12 casos

espanolEl manejo de los cuellos N0 en pacientes con carcinoma epidermoide de cabeza y cuello es controvertido. Objetivo. Demostrar la eficacia diagnostica de la biopsia del ganglio centinela (GC) en los pacientes con carcinoma epidermoide oral con cuello clinicamente negativo. Metodologia. Se realiza un estudio prospectivo de 12 pacientes consecutivos, hasta el momento, con carcinoma epidermoide oral de cualquier tamano y cuello clinicamente negativo que no habian recibido tratamiento antitumoral, asistidos en el S. de Cirugia Maxilofacial del area del H.U.V.M de Sevilla. A estos pacientes se les realiza una linfografia cervical con nanocoloides -Tc 99 para localizar el GC, y una dosis de recuerdo antes de iniciar el tto quirurgico. Durante la cirugia se localiza el GC con la sonda y se extirpa, se completa la diseccion cervical funcional y la extirpacion de la lesion con posteriores estudios histologicos independientes. Resultados. indice de linfolocalizacion: 91%, indice de radiolocalizacion 100%, falsos negativos 0%, la sensibilidad y VPN del 100%, cocientes de probabilidades positivo > 10 y negativo EnglishIManagement of the N0 neck in patients with head and neck squamous cell carcinoma remains controversial. Objective. To evaluate the feasibility and predictive ability of the sentinel node (SN) localization-biopsy technique for patients with squamous cell carcinoma of the oral cavity and clinically negative necks. Methodology. We realize a prospective study of 12 consecutive patients at present, with squamous cell carcinoma oral and clinically negative necks. These patients had not recived treatment against tumor and they were assited by Maxillofacial Surgery Service of HUVM from Seville. All patients received a cervical Tc99mlymphoscintigraphy to localize the sentinel node and a new dose before surgery. Intraoperatively, the sentinel node is localized and it is removed separately before tumor resection and elective functional neck dissection. The different anatomic specimens are sent for independent histological examination. Results. lympholocalization 91%, radiolocalization 100%, false negative 0%, sensitivity and NPV 100%, likely hood ratios > 10 and likely negative ratios Conclusions. The technique allows identification of SN-metastases and shows promise in guiding functional neck dissection (FIS-2002 subvention).