Sentinel lymph node biopsy for early oral cancers: Westmead Hospital experience

Abdul-Razak, Muzib; Chung, Hsiang; Wong, Eva; Veness, Michael J.; Farlow, David; Coleman, Hedley; Morgan, Gary J.

doi:10.1111/ans.13853

Cited by 20 publications

(7 citation statements)

References 27 publications

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“…Two authors individually collected data from included articles in forms commensurate with each other. Diagnostic accuracy, represented by DOR, summary receiver operating characteristic (SROC) curve, and area under the curve (AUC), was calculated 1,5,11–102 . DOR was calculated as (true positive [TP]/false positive [FP])/(false negative [FN]/true negative [TN]) to assess diagnostic accuracy with 95% confidence intervals (CIs).…”

Section: Methodsmentioning

confidence: 99%

Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta‐Analysis

Kim

et al. 2020

The Laryngoscope

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Objective We assessed the diagnostic accuracy of sentinel lymph node biopsy (SLNB) for detecting neck nodal metastasis in early oral squamous cell carcinoma (OSCC) as an alternative to elective neck dissection. Study Design A systematic search for relevant literature was conducted in the PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases. Methods Two reviewers individually searched the five databases up to November 2019. For studies that met inclusion criteria, data on patient diagnoses were pooled, including true positives, true negatives, false positives, and false negatives. Methodological quality was checked with the Quality Assessment of Diagnostic Accuracy Studies (version 2) tool. Results In total, 98 observational or retrospective studies were included. The diagnostic odds ratio of SLNB was 326.165 (95% confidence interval [CI]: 231.477–459.587; I2 = 0%). The area under the summary receiver operating characteristic curve was 0.982. Sensitivity was 0.827 (95% CI: 0.804–0.848), and specificity was 0.981 (95% CI: 0.975–0.986). The correlation between sensitivity and the false positive rate was −0.076, which indicates that heterogeneity did not exist. Subgroup analyses were performed with the subgroups reference test type, publication year, and study type. No significant difference was found within the reference test type subgroup. However, differences within the publication year and study type subgroups were significant, where the retrospective study subgroup was significantly more sensitive and specific than the prospective study subgroup. Conclusion Results of this meta‐analysis imply that the high specificity of SLNB supports its role as a diagnostic tool for patients with clinical tumor stage (CT)1‐2 clinically negative (N0) OSCC. More studies should be done to further verify the results of this study. Level of Evidence 2a Laryngoscope, 131:E459–E465, 2021

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Section: Methodsmentioning

confidence: 99%

Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta‐Analysis

Kim

et al. 2020

The Laryngoscope

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“…A total of seven studies with 457 patients were included in the meta-analysis 16,26,27,33,34,37,47 . The eligibility of the articles was determined by the data provided in each article.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic yield of sentinel lymph node biopsy in oral squamous cell carcinoma T1/T2-N0: systematic review and meta-analysis

Magariños

Ajuria

Marichalar-Mendía

et al. 2021

International Journal of Oral and Maxillofacial Surgery

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“…The mean number of SLNs detected by lymphoscintigraphy or single-photon emission CT with CT (SPECT/CT) was 2 to 3 in N0 early oral cancer [5, 10, 12], and the most common location of SLNs was level I to III using RI [29]. Regarding the location of SLNs detected by CTL, Honda et al [2] reported SLNs at level I to III; in our study, SLNs were at level I to II and in the sublingual region.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, 70 to 80% of patients with early oral cancer who underwent ND may experience complications such as facial nerve paralysis or shoulder dysfunction. Therefore, the concept of the sentinel lymph node (SLN), which is the first lymph node to receive drainage from a primary tumor, has recently been applied in detecting early lymph node metastasis in oral cancer patients [1–12], and SLN biopsy (SLNB) has been demonstrated to be less invasive than prophylactic ND. Although SLN detection using radioisotope (RI) tracers is commonly performed [4, 5, 8–14], RI cannot be used in certain institutions due to restrictions regarding the handling of radioactive material [2].…”

Section: Introductionmentioning

confidence: 99%

CT lymphography for sentinel lymph node mapping of clinically N0 early oral cancer

et al. 2019

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BackgroundThe objectives of this retrospective study were to evaluate the usefulness of computed tomography lymphography (CTL) and to clarify the optimal timing of CTL in sentinel lymph node (SLN) mapping of clinically N0 early oral cancer.MethodsTwenty patients with clinically N0 early oral cancer underwent CTL with a 128 multi-detector row CT scanner to detect SLN the day before resection of primary tumor and SLN biopsy with indocyanine green (ICG) fluorescence guidance. CT scanning was performed in the first 10 patients at 2, 5, and 10 min after submucosal injection of iopamidol and in the remaining 10 patients at 2, 3.5, 5, and 10 min after the injection of contrast medium. We evaluated the SLN detection rate at each scan timing and the number and location of SLNs. We evaluated whether CTL-enhanced SLNs could be identified intraoperatively as ICG fluorescent lymph nodes.ResultsSLNs were detected by CTL in 19 of the 20 patients (95.0%), and the mean number of SLNs was 2 (range, 1–4). All SLNs were located on the ipsilateral side; 35 of 37 SLNs were located at level I and II, and 2 SLNs were lingual lymph nodes. All SLNs could be detected 2 min and 3.5–5 min after contrast medium injection, and CTL-enhanced SLNs could be identified intraoperatively as fluorescent lymph nodes.ConclusionsCTL could facilitate the detection of SLNs in early oral cancer, and the optimal timing of CT scanning was at 2 and 5 min after injection of contrast medium.

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Sentinel lymph node biopsy for early oral cancers: Westmead Hospital experience

Abstract: SLNB for early OCSCC is technically feasible in an Australian setting. It has a high NPV and can potentially identify at-risk lymphatic basins outside the traditional selective neck dissection levels even in well-lateralized lesions.

Cited by 20 publications

References 27 publications

Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta‐Analysis

Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta‐Analysis

Diagnostic yield of sentinel lymph node biopsy in oral squamous cell carcinoma T1/T2-N0: systematic review and meta-analysis

CT lymphography for sentinel lymph node mapping of clinically N0 early oral cancer

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