Sentinel Node Biopsy in N0 Squamous Cell Carcinoma of the Oral Cavity and Oropharynx in Patients Previously Treated With Surgery or Radiation Therapy

Abstract

Objectives:To assess the feasibility of sentinel lymph node (SLN) localization and to determine the predictive value of SLN biopsy for occult neck metastases in patients previously treated with surgery or radiation therapy and with N0 squamous cell carcinoma of the oral cavity or oropharynx.Design: Prospective case series.Setting: Tertiary academic hospital.Patients: Eleven patients with T1 to T4 N0 squamous cell carcinoma of the oral cavity or oropharynx.

Feasibility and diagnostic performance of sentinel node biopsy for staging cN0 oral squamous cell carcinoma in a previously treated neck

“…Only three other studies have investigated SNB in cohorts of patients with OSCC and previously treated necks; the studies are summarized in Table 4. The sensitivity rate was reported between 50% and 75% in the study of den Toom and NPVs of 91% and 100% 19,20,28 . The somewhat low sensitivity of 50% found in the study of den Toom et al has a wide 95% confidence interval of 22%–98%, which the authors suggest may be due to a low number of SN‐positive patients (7%) in the cohort.…”

“…The sensitivity rate was reported between 50% and 75% in the study of den Toom and NPVs of 91% and 100%. 19 , 20 , 28 The somewhat low sensitivity of 50% found in the study of den Toom et al has a wide 95% confidence interval of 22%–98%, which the authors suggest may be due to a low number of SN‐positive patients (7%) in the cohort. This is also an important factor in our study, with a positive rate of 13% compared to a rate of 23%–34% in patients with untreated necks.…”

Lymphatic drainage of sinonasal malignancies and the role of sentinel node biopsies

“…Long-term observations show an approximately fourfold higher complication rate after axillary dissection compared to SNB in the treatment of invasive breast carcinoma [8,9] , while the diagnostic accuracy of these procedures is comparable [12][13][14][15] . Recent studies have also demonstrated a comparable accuracy for SNB to selective neck dissection also in early oral and oropharyngeal squamous cell carcinoma [16][17][18][19][20] . In 2017, in a meta-analysis of 66 studies including more than 3500 patients with T1-2 cN0 oral squamous cell carcinoma (OSCC), SNB yielded a pooled sensitivity of 87% and a pooled negative predictive value of 94% [21] .…”

Preliminary study of indirect CT lymphography-guided sentinel lymph node biopsy in a tongue VX2 carcinoma model

“…Recent studies consistently show high sensitivities (> 93%) of SLN biopsies for T1 and T2 head and neck SCC; the negative predictive value for the absence of cervical metastases was 91-100%. 5 It is likely that SLN biopsy will be recommended for T1 and T2 oral cavity squamous cell carcinomas exhibiting cN0 lymph nodes and it is possible that this could extend to all early-stage head and neck cancers. 2 Many studies have used lymphoscintigraphy when performing a SLN biopsy for head and neck cancer; 2,18 but traditional lymphoscintigraphy techniques require equipment that is not widely available in hospitals without a nuclear medicine department.…”