Abstract
Sentinel lymph node (SLN) biopsy has gained attention as a method of minimizing the extent of neck dissection with a similar survival rate as elective neck dissection in oral cancer. Indocyanine green (ICG) imaging is widely used in the field of surgical oncology. Real-time ICG-guided SLN imaging has been widely used in minimally invasive surgeries for various types of cancers. Here, we provide an overview of conventional SLN biopsy and ICG-guided SLN mapping techniques for oral cancer. Although ICG has many strengths, it still has limitations regarding its potential use as an ideal compound for SLN mapping. The development of novel fluorophores and imaging technology is needed for accurate identification of SLNs, which will allow precision surgery that would reduce morbidities and increase patient survival.
Highlights
Oral cancer is the sixth most common cancer, with over 0.6 million newly diagnosed patients every year worldwide [1]
In a metaanalysis of the diagnostic evaluation of Sentinel lymph node (SLN) biopsies performed on 3566 patients with early head and neck squamous cell carcinomas published in 2017, Liu et al reported a clinically meaningful identification rate, sensitivity, and negative predictive value of 96.3%, 87.0%, and 94.0%, respectively [4]
In the case of oral cancers localized in the mouth floor, SLN biopsy with radiography has lower sensitivity due to the shine-through effect
Summary
Oral cancer is the sixth most common cancer, with over 0.6 million newly diagnosed patients every year worldwide [1]. Sentinel lymph node (SLN) biopsy has gained attention as a method of minimizing the extent of neck dissection with a similar level of survival rate as END. In a metaanalysis of the diagnostic evaluation of SLN biopsies performed on 3566 patients with early head and neck squamous cell carcinomas published in 2017, Liu et al reported a clinically meaningful identification rate, sensitivity, and negative predictive value of 96.3%, 87.0%, and 94.0%, respectively [4]. To overcome the drawbacks of the previous radiotracer-based SLN detection methods, the ICG-guided SLN mapping has been introduced This technique is a real-time, high-resolution, non-ionizing, and inexpensive method that is easy to use and does not affect the surgical anatomy. We reviewed the existing literature on ICG-guided SLN mapping techniques in patients with oral cancer to examine the current techniques and their limitations and propose future directions for more accurate fluorescence image-guided surgical technology. Clinical trials currently in progress on the ClinicalTrials.gov website were searched and organized using the key terms aforementioned
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