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Infrared guided surgery for localization of sentinel lymph node in early oral cavity cancer

Grant number: 12/07459-6
Support type:Regular Research Grants
Duration: August 01, 2012 - July 31, 2014
Field of knowledge:Health Sciences - Medicine
Principal Investigator:André Lopes Carvalho
Grantee:André Lopes Carvalho
Home Institution: Hospital do Câncer de Barretos. Fundação Pio XII (FP). Barretos , SP, Brazil
Assoc. researchers: Cristovam Scapulatempo Neto

Abstract

The SLN is a well-established method in applications such as melanoma and breast cancer, but in oral cavity cancer, presents some difficulties that must be overcome, requiring technical refinements to gain greater acceptance. It is used routinely with nuclear medicine and patent blue dye. In the early stages of oral cavity cancer the use of sentinel lymph node is justified, because a neck dissection procedure can provide up to 85% of negative neck dissection specimens. In the presence of positive sentinel lymph node (SLN), it's indicated the complementary surgical treatment of neck dissection. However, among the difficulties in oral cancer, stands out the proximity of the injection point and the location of the SLN, which causes the shine-through phenomenon by the high emission of the primary tumor.A new alternative to these traditional methods is the use of near infrared light with wavelengths from 700 to 900 nm (NIR) and fluorescent dyes such as green indocyanine. The NIR light has a higher potential to penetrate living tissues allowing the lymph node can be viewed through the overlying structures that highlights the lymph node, including the skin. Thus, the location of LS can be determined in real time of surgery, even before the skin incision. As infrared light is invisible to the human eye, so specialized equipment developed for this purpose are need.This methodology is emergent and requires metodological standardization and optimization studies to be applied in head and neck surgery with the potential to supplant traditional methods. (AU)