Sentinel Node Biopsy in Lieu of Neck Dissection for Staging Oral Cancer

Rigual, Néstor R.; Loree, Thom R.; Frustino, Jennifer; Jayaprakash, Vijayvel; Cohan, David; Sullivan, Maureen; Kuriakose, Moni Abraham

doi:10.1001/jamaoto.2013.3863

Cited by 35 publications

(25 citation statements)

References 11 publications

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“…For SND/ND demonstrating greater than one positive lymph node or with extracapsular spread, perineural or perivascular spread, adjuvant chemoradiotherapy was recommended for definitive, further management. These recommendations were based upon previous clinical experience and studies published on SNB . All patients who underwent further adjuvant therapy after ND received chemoradiotherapy with cisplatin‐based regimens.…”

Section: Methodsmentioning

confidence: 99%

“…Controversy exists regarding the consequences of SND in patients with a clinically negative neck with no found nodal disease. Studies indicate that early stage OSCC presents with cervical node metastasis in about 20% to 30% of cases . As such, clinical observation in the cN0 may be a viable option to avoid the morbidity of SND.…”

Section: Introductionmentioning

confidence: 99%

“…Current practice is dynamic, as sentinel node biopsy has been an emerging tool in determining the staging criteria for OSCC. An initial study conducted at our medical center, with 33 patients, found that the sensitivity and negative predictive value to determine OSCC staging by SNB alone was 71% and 94%, respectively . Studies indicate SNB is more cost effective and is less invasive and patient favored .…”

Section: Introductionmentioning

confidence: 99%

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Sentinel lymph node biopsy for management of the N0 neck in oral cavity squamous cell carcinoma

Loree

Popat

Burke

et al. 2019

Journal of Surgical Oncology

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Background and Objectives The management of the clinically N0 (cN0) neck is controversial for early stage squamous cell carcinoma of the oral cavity (OSCC). This paper represents a single institution series analyzing the efficacy of sentinel lymph node biopsy (SNB) for early stage oral cavity cancers. Methods From 2005 to 2017, 108 patients with cN0 OSCC were treated with primary resection and SNB. Patients with positive biopsy results proceeded to neck dissection with or without adjuvant chemoradiotherapy. Mean follow‐up for the entire cohort was 50.8 months (range: 8‐147 months). Clinically, 56 patients were T1N0, 49 patients were T2N0, and three patients were T3N0 or greater. Results Disease‐specific survival was 93% within the entire cohort. Sentinel lymph nodes were identified in 95.4% of patients. Twenty one patients had a positive biopsy. There were seven false‐negative biopsies. The overall rate of nodal disease was 26%. Accuracy of node biopsy was 93%, with sensitivity of 75%, and negative predictive value of 91%. Recurrence rate was 19% (20/108), with an overall survival of 60% in this subgroup. Conclusion SNB is a safe, effective, and well tolerated method for staging cN0 OSCC.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sentinel lymph node biopsy for management of the N0 neck in oral cavity squamous cell carcinoma

Loree

Popat

Burke

et al. 2019

Journal of Surgical Oncology

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“…33 The techniques and methodology for SLN identification in head and neck cancers have been widely debated and are still under investigation [ Tables 1 and 2]. 5,14,15,22,24,[27][28][29][30][31][34][35][36][37][38][39][40][41][42][43][44][45][46] Shoaib et al suggested a protocol involving preoperative lymphoscintigraphy, intraoperative blue dye and gamma probe localisation [ Figure 2]. 30 This technique is based on observing the route of lymphatic flow via imaging after the injection of a radioactive contrast agent near the primary tumour.…”

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confidence: 99%

Sentinel Lymph Node Biopsy: A new approach in the management of head and neck cancers

Sharma¹,

Koshy²,

Grover³

et al. 2017

SQUMJ

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‫شارما‬ ‫بوشان‬ ‫جروفر,‬ ‫سونال‬ ‫كوشي,‬ ‫جورج‬ ‫شارما,‬ ‫ديبيت‬ abstract: Cervical lymph node metastasis affects the prognosis and overall survival rate of and therapeutic planning for patients with head and neck squamous cell carcinomas (HNSCCs). However, advanced diagnostic modalities still lack accuracy in detecting occult neck metastasis. A sentinel lymph node biopsy is a minimally invasive auxiliary method for assessing the presence of occult metastatic disease in a patient with a clinically negative neck. This technique increases the specificity of neck dissection and thus reduces morbidity among oral cancer patients. The removal of sentinel nodes and dissection of the levels between the primary tumour and the sentinel node or the irradiation of target nodal basins is favoured as a selective treatment approach; this technique has the potential to become the new standard of care for patients with HNSCCs. This article presents an update on clinical applications and novel developments in this field. A s opposed to primary tumours, metastasis is responsible for the high mortality rate of most cancer patients; moreover, cancer cells primarily invade the regional lymph nodes before spreading to other parts of the body. Keywords1 Genetic instability results in tumour cell heterogeneity, leading to the emergence of metastatic clones and dissemination of the cancer from the primary tumour site.2 Malignant cells metastasise due to an interaction between the host factors and tumour cells. Genes related to the extracellular matrix, adhesion, motility and protease inhibition constitute a significant part of the metastatic process. The migration and invasion of cancer cells into the lymphatic system is governed by a variety of intricate genotypic, phenotypic and microenvironmental processes. After entering the lymphatic draining channels, the tumour cells metastasise to the regional lymph nodes in the neck and form the metastatic foci.4 Macrometastases refer to lymph nodes that appear suspicious on clinical or radiographical examinations; in contrast, nodal metastases-which are not detectable by imaging methods or physical examination-indicate occult or subclinical metastasis. Hermanek microscopically differentiated occult metastases into macrometastases (metastatic deposits of >2 mm), micrometastases (metastatic deposits of <2 mm) and isolated or small clusters of tumour cells (metastatic deposits of <0.2 mm).5 Isolated tumour cells (ITCs) can also be defined as a cluster of ≤200 tumour cells visible on one histology slide; these cells can further be categorised into those detectable by light microscopy, immunohistochemistry or molecular methods.6 Chemoradiation or elective neck dissection (END) should be considered in patients

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“…1,10,11 Even with the application of sentinel node biopsy, 6% to 9% of the occult nodal metastases still remain undetected. 12,13 The presence of neck nodal metastases is a crucial prognostic determinant for the patient's Upon completion of this activity you will be able to: • describe which tumor characteristics of an oral squamous cell carcinoma (OSCC) are associated with regional (nodal) metastasis. • list the "unfavorable" growth parameters of an OSCC associated with regional metastasis.…”

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confidence: 99%

Poor Correlation of Histologic Parameters Between Biopsy and Resection Specimen in Early Stage Oral Squamous Cell Carcinoma

Dik

Ipenburg

Adriaansens

et al. 2015

American Journal of Clinical Pathology

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Sentinel Node Biopsy in Lieu of Neck Dissection for Staging Oral Cancer

Cited by 35 publications

References 11 publications

Sentinel lymph node biopsy for management of the N0 neck in oral cavity squamous cell carcinoma

Sentinel lymph node biopsy for management of the N0 neck in oral cavity squamous cell carcinoma

Sentinel Lymph Node Biopsy: A new approach in the management of head and neck cancers

Poor Correlation of Histologic Parameters Between Biopsy and Resection Specimen in Early Stage Oral Squamous Cell Carcinoma

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