The sentinel node concept in head and neck cancer: solution for the controversies in the n0 neck?

Abstract

Sentinel lymphadenectomy correctly identified the stage of metastatic disease in 97% of patients in cases in which up to three sentinel nodes were identified. If only the lymph node with the highest tracer activity had been excised, 39% of cancer-positive necks would have been missed. Selective ND identified metastatic disease in the additional 3% of patients.

Significance of clinical stage, extent of surgery and outcome in cutaneous squamous cell carcinoma of the head and neck

“…Although some authors consider sentinel lymph node biopsy techniques as standard of care, they still have no proven survival benefit in the management of head and neck CSCC, and their use remains unequivocally investigational. 18 It is important to note that metastatic head and neck CSCC comprise a heterogeneous group for diagnosing, treating and accurately assessing outcome.…”

The Diagnostic Accuracy of Reverse Transcription-PCR Quantification of Cytokeratin mRNA in the Detection of Sentinel Lymph Node Invasion in Oral and Oropharyngeal Squamous Cell Carcinoma: A Comparison with Immunohistochemistry

“…Until recently, a neck dissection was advocated routinely both to assess nodal involvement and to remove occult minimal residual cancer (2). A more recent approach consists of limiting lymph node surgery to a staging procedure by taking only the sentinel lymph nodes (SLN) which are representative of the whole neck node system (3). Such a strategy aims to permit more thorough analysis of only a few lymph nodes to enhance the sensitivity and the specificity of the diagnosis of lymph node invasion and thus select only pN+ patients on whom to perform a neck dissection.…”

The Role of Sentinel Lymph Node Biopsy in Head and Neck Cancers and Its Application Areas

“…Hence, removal of a number of lymph nodes rather than a single lymph node is recommended when SLNB is conducted. SLNB method gave an accurate result in 97% of the patients in a study in which 3 sentinel lymph nodes were removed (19). When only the first sentinel lymph node was considered a false negativity at a rate of 39% was detected.…”