Sentinel node biopsy in node negative early oral cancers: Solution to the conundrum!

Vaish, Richa; Mittal, Neha; Mahajan, Abhishek; Rane, Swapnil; Agrawal, Archi; D’Cruz, Anil

doi:10.1016/j.oraloncology.2022.106070

Cited by 6 publications

(2 citation statements)

References 41 publications

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“…SLNB has become an important tool for the treatment of OTSCC [ 7 ]. SLNB allows for the identification of the first lymph node that drains the tumor area, and its biopsy can provide valuable information regarding the presence or absence of occult neck metastasis [ 19 , 20 , 21 , 22 ]. In recent years, several studies have investigated the diagnostic and prognostic value of SLNB in OTSCC [ 23 , 24 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”

Ionna,

Pavone,

Aversa

et al. 2024

Cancers

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Oral tongue squamous-cell carcinoma (OTSCC) is the most prevalent malignancy in the head and neck region. Lymphatic spread, particularly to cervical lymph nodes, significantly impacts 5-year survival rates, emphasizing the criticality of precise staging. Metastatic cervical lymph nodes can decrease survival rates by 50%. Yet, elective neck dissection (END) in T1–2 cN0 patients proves to be an overtreatment in around 80% of cases. To address this, sentinel lymph node biopsy (SLNB) was introduced, aiming to minimize postoperative morbidity. This study, conducted at the ENT and Maxillofacial Surgery department of the Istituto Nazionale Tumori in Naples, explores SLNB’s efficacy in early-stage oral tongue squamous-cell carcinoma (OTSCC). From January 2020 to January 2022, 122 T1/T2 cN0 HNSCC patients were enrolled. Radioactive tracers and lymphoscintigraphy identified sentinel lymph nodes, aided by a gamma probe during surgery. Results revealed 24.6% SLN biopsy positivity, with 169 SLNs resected and a 21.9% positivity ratio. The study suggests SLNB’s reliability for T1-2 cN0 OTSCC patient staging and early micrometastasis detection.

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Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”

Ionna,

Pavone,

Aversa

et al. 2024

Cancers

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“…In this setting, the role of sentinel node biopsy (SNB) in the clinically negative neck is more and more recognized. When compared with standard imaging modalities, SNB is the best-performing diagnostic tool for staging patients with cN0 HNSCC [58,59], with a negative predictive value of 96% [60] and a specificity of up to 99% [61]. Two large phase III randomized controlled trials confirmed that neck dissection can be safely avoided when SNB is negative, without affecting survival [62,63].…”

Section: Cervical Lymph Node Assessmentmentioning

confidence: 99%

Role of 18F-FDG PET/CT in Head and Neck Squamous Cell Carcinoma: Current Evidence and Innovative Applications

Caldarella,

De Risi,

Massaccesi

et al. 2024

Cancers

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This article provides an overview of the use of 18F-FDG PET/CT in various clinical scenarios of head–neck squamous cell carcinoma, ranging from initial staging to treatment-response assessment, and post-therapy follow-up, with a focus on the current evidence, debated issues, and innovative applications. Methodological aspects and the most frequent pitfalls in head–neck imaging interpretation are described. In the initial work-up, 18F-FDG PET/CT is recommended in patients with metastatic cervical lymphadenectomy and occult primary tumor; moreover, it is a well-established imaging tool for detecting cervical nodal involvement, distant metastases, and synchronous primary tumors. Various 18F-FDG pre-treatment parameters show prognostic value in terms of disease progression and overall survival. In this scenario, an emerging role is played by radiomics and machine learning. For radiation-treatment planning, 18F-FDG PET/CT provides an accurate delineation of target volumes and treatment adaptation. Due to its high negative predictive value, 18F-FDG PET/CT, performed at least 12 weeks after the completion of chemoradiotherapy, can prevent unnecessary neck dissections. In addition to radiomics and machine learning, emerging applications include PET/MRI, which combines the high soft-tissue contrast of MRI with the metabolic information of PET, and the use of PET radiopharmaceuticals other than 18F-FDG, which can answer specific clinical needs.

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Historical milestones in the evolution of the procedure of neck dissection

Devaraja

2024

World j. otorhinolaryngol.-head neck surg.

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ObjectiveAlthough neck dissection has evolved to become an integral part of the surgical armamentarium for managing head and neck cancers, the manner in which the procedure has reached its present state is worth revisiting.Data SourcesPublished original articles, reviews, clinical practice guidelines, and consensus statements related to the basis, indication, and classification of the neck dissection.MethodsThis review discusses some of the critical milestones before and after the description of the procedure of neck dissection by George Crile Sr. in 1905, which eventually played a role in the evolution of this commonly performed oncosurgical procedure.ResultsSeveral large observational studies of the twentieth century and multicentric randomized trials at the turn of the twenty‐first century have shaped neck dissection into a safe and reliable oncosurgical procedure.ConclusionsFrom being a radical surgery that was done mostly in large nodal diseases for curative or palliative purposes to becoming a simple procedure that is carried out even in node‐negative cases of head and neck cancers for prognostic purposes, the procedure of neck dissection has come a long way and continues to evolve.

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Sentinel node biopsy in node negative early oral cancers: Solution to the conundrum!

Cited by 6 publications

References 41 publications

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”

Sentinel Lymph Node Biopsy (SLNB) for Early-Stage Head and Neck Squamous-Cell Carcinoma of the Tongue: Twenty Years of Experience at I.N.T. “G.Pascale”

Role of 18F-FDG PET/CT in Head and Neck Squamous Cell Carcinoma: Current Evidence and Innovative Applications

Historical milestones in the evolution of the procedure of neck dissection

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