A research about sentinel node micrometastasis in oral squamous cell carcinoma

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K16934
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Otorhinolaryngology
• Research Institution: Fukushima Medical University
• Principal Investigator: Kobari Takehiro 福島県立医科大学, 公私立大学の部局等, 助手 (40795085)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: センチネルリンパ節 / センチネルリンパ節ナビゲーション手術 / 微小転移 / 予防的頸部郭清術

Outline of Final Research Achievements

In this study, we performed immunostaining on the sentinel lymph node (SN) identified by Sentinel Node Navigation Surgery(SNNS) in 31 patients with early stage oral cancer, and re-evaluated the lesion of SN to determine the presence or absence of metastases and the size of metastatic lesion, and then integrated them and prognosis information.Finally We examined the size of SN micro-metastases that could omit the prophylactic neck dissection.
Six out of 31 cases were positive for SN metastases, and 5 cases underwent neck dissection. The case in which SN metastasis was 0.57 mm, which was the smallest case of SN metastasis, showed that a metastasis was observed in non-SN cervical lymph nodes. Therefore, from this study, it is difficult to define the micro-metastases diameter of SN that can omit prophylactic neck dissection, and it is considered necessary to increase the number of cases in the future.

Free Research Field

頭頸部外科学

Academic Significance and Societal Importance of the Research Achievements

SNの微小転移が定義可能となった場合、センチネルリンパ節ナビゲーション手術(SNNS)を行いSNが微小転移とみなされた上で頸部郭清術を省略し経過観察とすると、SNNSを行わずに原発巣切除のみで経過観察とするときに比べ術後の頸部転移・再発のリスクを減じ、さらに頸部郭清術を一律に行うときの合併症や後遺症のリスクを減じることが出来るようになる可能性があると考えられた。
本研究のみからは、予防的頸部郭清術を省略しうるSNの微小転移の大きさを定義することは困難であり、今後症例数を増やし頭頸部癌におけるSNの微小転移を定義し、根治術のさらなる個別化、低侵襲化を図っていくことが重要と考えられた。