Centralised pathology service for sentinel node biopsy in oral cavity cancer: The Southeast England Consortium experience

Abstract

Background Sentinel lymph node biopsy is an increasingly recognised option for accurate staging and subsequent management of the clinically negative neck in early stage oral cavity squamous cell carcinoma. However, the technique is currently underused due to several logistic constraints including increased burden on pathology services. Here, we describe the feasibility of an outsourced centralised pathology processing and reporting service for sentinel lymph node biopsies in oral cavity squamous cell carcinoma. Patients and methods The Southeast England Consortium comprises four surgical centres utilising a central pathology service. Consecutive cases between January 2016 and February 2020 were retrospectively evaluated for survival outcomes and laboratory turnaround times. Results Twenty‐eight per cent from a cohort of 139 patients had positive sentinel nodes. There was a trend towards greater overall, disease‐free and disease‐specific survival (OS, DFS and DSS, respectively) in sentinel node negative compared to sentinel node positive patients, but these differences were not statistically significant. The sensitivity, negative predictive value and false negative rate were 92.8%, 97.0% and 6.8%, respectively. The mean and mode laboratory TAT were 5 and 4 working days, respectively. Conclusion An outsourced centralised pathology service is a feasible option to widen the availability of sentinel node biopsy in oral cavity squamous cell carcinoma.

Incidental Thyroid Tissue in Sentinel Nodes From Oral Squamous Cell Carcinoma

“…Retrospective case note review of SNB procedures performed for cT1-T2 OSCC within South of England SNB consortium between 2017 and 2021. 8 All SNs within the five-center consortium were analyzed by a central specialist Head and Neck pathology service based at Guys Hospital, London (Viapath). A previously published analysis 8 showed that the consortium had an SNB positive rate of 28% with sensitivity, negative predictive value, and false negative rate of 92.8%, 97.0% and 6.8%.…”

“…Retrospective case note review of SNB procedures performed for cT1‐T2 OSCC within South of England SNB consortium between 2017 and 2021 8 . All SNs within the five‐center consortium were analyzed by a central specialist Head and Neck pathology service based at Guys Hospital, London (Viapath).…”

“…The purpose of this article is to review cases of incidental thyroid cells (TC) found in sentinel nodes (SNs) from patients undergoing SNB for OSCC within the South of England SNB consortium. 8 We aim to assess if there is a higher than expected rate of TC within SNB cases, and to understand if identification is aided by lymphatic mapping and/or pathological examination. Furthermore, we will provide advice regarding ongoing management of TC in the context of SNB patients.…”