Long term‑follow‑up multicenter feasibility study of ICG fluorescence‑navigated sentinel node biopsy in oral cancer

Yokoyama,Junkichi; Hasegawa,Yasuhisa; Sugasawa,Masashi; Shiotani,Akihiro; Murakami,Yoshiko; Ohba,Shinichi; Kohno,Naoyuki

doi:10.3892/mco.2020.2111

Long term‑follow‑up multicenter feasibility study of ICG fluorescence‑navigated sentinel node biopsy in oral cancer

Authors:
- Junkichi Yokoyama
- Yasuhisa Hasegawa
- Masashi Sugasawa
- Akihiro Shiotani
- Yoshiko Murakami
- Shinichi Ohba
- Naoyuki Kohno
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Affiliations: Department of Otolaryngology‑Head and Neck Surgery, Kyorin University School of Medicine, Tokyo 181‑8611, Japan, Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464‑8681, Japan, Department of Otolaryngology‑Head and Neck Surgery, Saitama Medical University International Medical Center, Saitama 350‑1298, Japan, Department of Otolaryngology‑Head and Neck Surgery, National Defence Medical College, Tokorozawa, Saitama 359‑8513, Japan, Department of Pathological Diagnosis, Nagoya Medical Center, Nagoya, Aichi 460‑0001, Japan, Department of Otolaryngology‑Head and Neck Surgery, Juntendo University School of Medicine, Tokyo 113‑8341, Japan
Published online on: August 12, 2020 https://doi.org/10.3892/mco.2020.2111
Article Number: 41
Copyright: © Yokoyama et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

In the current study, the utility of sentinel node (SN) identification using indocyanine green (ICG) was investigated for oral cancers in the clinical N0 stage. The current study was a prospective, multicentre, phase II clinical trial that was conducted in Japan. A total of 18 patients were included. Before surgery, the patients underwent lymphoscintigraphy to map the SNs. During surgery, radioactive isotope (RI) mapping was used to detect the SNs, and ICG was subsequently injected. ICG mapping of the SNs was then performed through the skin. The primary tumour was resected, and a neck flap was elevated for neck dissection, followed by SN biopsy (SNB) using RI or ICG mapping. With the RI method, a total of 63 SNs were detected. Among these SNs, 8 (12.7%) were positive for metastasis, including those with isolated tumour cells (ITCs). The median number of SNs per patient identified by SNB was 4. With the ICG method, a total of 67 SNs were detected. Among these SNs, 7 (10.4%) were positive for metastasis, including those with ITCs. The median number of SNs per patient identified by SNB was 4 (range, 1‑6). The 5‑year overall survival (OS) of all patients was 83.3%, and the 5‑year disease‑free survival (DFS) of all patients was 76.7%. The neck compression technique is a simple method that can be used to facilitate surgical procedures of ICG fluorescence navigated SNB for head and neck cancer.

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