A biopsy of the signaling lymph node in case of early oral cancer (cT1–2N0M0) by the lymphoscintigraphic method: one center study

The study objective is to evaluate the possibility of determining the signaling lymph node (SLN)  in oral cancer (T1–2N0M0) with lymphoscintigraphic method.

Materials and methods. In 2016–2018,  SLNs were determined for 23 patients with oral cancer (cT1–2N0M0): for 15 patients with cancer of the tongue, for 8 patients with cancer of the floor of the mouth cavity. SLNs were determined by radiolymphoscintigraphic method by peritumoral administration of Tehnefit radiopharmaceutical in a dose of 40 to 80 MBq, depending on the timing of the signal lymph node biopsy. Visualization of the signaling lymph node was carried out by planar scintigraphy and single-photon emission computed tomography combined with x-ray computed tomography. Intraoperative SLN was detected using intraoperative radiometry using a gamma probe.

Results. In cancer of the floor of the mouth, SLNs were identified only in 2 (25 %) of 8 cases. In cancer of the language, SLN were identified in 14 (93.3 %) of 15 cases. In total, SLNs were diagnosed with cancer in 17 patients. In 4 (26.7 %) of 15 patients, cancer metastases in SLNs were identified. False negative results were obtained in 6.7 % of cases.

Conclusion. A biopsy of the SLN by the lymphoscintigraphic method has a high diagnostic value for staging the early stages of cancer of the tongue.

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