Research

Sentinel Node Biopsy at Canniesburn Hospital

Head and Neck Cancer

Several cancers including Head and Neck Cancer spread via lymphatic vessels to the regional draining lymph nodes. Knowledge of tumour spread is important in deciding the management of patients with Head and Neck Cancer, yet currently the only way of determining spread with a high degree of accuracy is to perform a formal lymph node dissection of the neck lymph nodes. Since this procedure carries with it several adverse effects, surgeons are keen to avoid the procedure for suspected early disease; however the treatment of early tumour spread is more beneficial than treatment of more extensive disease. The decision to perform a neck dissection on patients with suspected early disease can therefore be difficult to make.

At Canniesburn Hospital, we are currently performing a procedure called sentinel node biopsy in patients with oral cancer to see if the sentinel node is an accurate predictor of the regional node basin. A radioactive colloid and a blue dye are injected into the tissues that surround the tumour and are followed to the first draining lymph node. The lymph node is removed and examined for the presence of tumour. If the sentinel node is shown to be an accurate predictor of nodal metastases in patients with oral cancer, we may be able to avoid unnecessary major surgery in patients with early disease.

A 'hot' blue-staining sentinel node in the neck
 

Malignant Melanoma

Malignant melanoma spreads via lymphatics to the regional lymph nodes in the groin, axilla or neck and the sentinel node has been shown to be an accurate predictor of spread of this disease.

What is not known, however, is if sentinel node biopsy and subsequent lymph node dissection, if the sentinel node contains tumour, confers a survival benefit compared to our current management protocols.

A blue sentinel node in the groin