Sentinel lymphadenectomy in squamous cell carcinoma of the pharynx and larynx

: The study included 20 patients with carcinoma of the pharynx and larynx. The incidence of metastases was compared between sentinel lymph nodes and the rest of lymph nodes in resected material. Patient inclusion criteria were primary tumor verified as squamous cell carcinoma by preoperative histopathology and negative clinical neck finding (cN0). Human serum albumin radiocolloid labeled with radioactive technetium-99m 0.5 mCi (18 MBq) was used. In two patients (with tumors of the hypopharynx and glottis), lymph nodes were not preoperatively visualized by scintigraphy. A total of 32 lymph nodes (range 0-4), were visualized. All nodes were found in regions II-IV, mostly in region II. In three patients, sentinel lymph nodes were detected bilaterally. Twenty six selective neck resections were performed (bilateral in six patients). A total of 319 (mean 12) lymph nodes were isolated in resected material, 7 of them were positive, all ipsilateral. A positive definitive histopathology finding was recorded in five patients. Three patients had one positive lymph node each (pN1), all sentinel lymph nodes. In one patient, positive sentinel lymph node histopathology was associated with tumor lesions detected in other lymph nodes (pN2b). One patient had false negative result. Study results confirmed the lymphatic drainage of the upper aerodigestive tract and metastasizing area from tumors of this localization are constant and predictable.