Correlation between theoretical anatomical patterns of lymphatic drainage and lymphoscintigraphy findings during sentinel node detection in XXXX .

@entity1 @entity135 @entity5 @entity75 @entity3 @entity320
PURPOSE: In the diagnosis of @entity135 , lymphatic drainage is complex and highly variable. As regional lymph node @entity3 is one of the most important prognostic factors, lymphoscintigraphy can help map individual drainage patterns. The aim of this study was to compare the results of lymphoscintigraphy and sentinel lymph node (SLN) detection with theoretical anatomical patterns of lymphatic drainage based on the location of the primary @entity5 in @entity1 with @entity135 . We also determined the percentage of discrepancies between our lymphoscintigraphy and the theoretical location of nodal drainage predicted by a large lymphoscintigraphic database, in order to explain recurrence and false-negative SLN biopsies. METHODS: In this retrospective study of 152 @entity1 with @entity135 , the locations of the SLNs on lymphoscintigraphy and detected intraoperatively were compared with the lymphatic drainage predicted by on-line software based on a large @entity320 database. RESULTS: All @entity1 showed lymphatic drainage and in all @entity1 at least one SLN was identified by lymphoscintigraphy. Of the 152 @entity1 , 4 had a @entity75 in areas that were not described in the Sydney @entity320 Unit database, so agreement could only be evaluated in 148 @entity1 . Agreement between lymphoscintigraphic findings and the theoretical lymphatic drainage predicted by the software was completely concordant in 119 of the 148 @entity1 (80.4  %, 95  % CI 73.3  -  86  %). However, this concordance was partial (some concordant nodes and others not) in 18 @entity1 (12.2  %, 95  % CI 7.8  -  18.4  %). Discordance was complete in 11 @entity1 (7.4  %, 95  % CI 4.2  -  12.8  %). CONCLUSION: In @entity320 of the head and neck there is a high correlation between lymphatic drainage found by lymphoscintigraphy and the predicted drainage pattern and basins provided by a large reference database. Due to unpredictable drainage, preoperative lymphoscintigraphy is essential to accurately detect the SLNs in @entity135 .
