Sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma.
AffiliationOtorhinolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, Rorschacherstrasse 95, 9007, St. Gallen, Switzerland. email@example.com
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AbstractThe appearance of lymph node metastases represents the most important adverse prognostic factor in head and neck squamous cell carcinoma. Therefore, accurate staging of the cervical nodes is crucial in these patients. The management of the clinically and radiologically negative neck in patients with early oral and oropharyngeal squamous cell carcinoma is still controversial, though most centers favor elective neck dissection for staging of the neck and removal of occult disease. As only approximately 30% of patients harbor occult disease in the neck, most of the patients have to undergo elective neck dissection with no benefit. The sentinel node biopsy concept has been adopted from the treatment of melanoma and breast cancer to early oral and oropharyngeal squamous cell carcinoma during the last decade with great success. Multiple validation studies in the context of elective neck dissections revealed sentinel node detection rates above 95% and negative predictive values for negative sentinel nodes of 95%. Sentinel node biopsy has proven its ability to select patients with occult lymphatic disease for elective neck dissection, and to spare the costs and morbidity to patients with negative necks. Many centers meanwhile have abandoned routine elective neck dissection and entered in observational trials. These trials so far were able to confirm the high accuracy of the validation trials with less than 5% of the patients with negative sentinel nodes developing lymph node metastases during observation. In conclusion, sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma can be considered as safe and accurate, with success rates in controlling the neck comparable to elective neck dissection. This concept has the potential to become the new standard of care in the near future.
CitationSentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma. 2009, 266 (6):787-93 Eur Arch Otorhinolaryngol
JournalEuropean Archives of Oto-Rhino-Laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology
- Elective neck dissection in oral carcinoma: a critical review of the evidence.
- Authors: Kowalski LP, Sanabria A
- Issue date: 2007 Jun
- Sentinel lymph node biopsy in node-negative squamous cell carcinoma of the oral cavity and oropharynx.
- Authors: Burns P, Foster A, Walshe P, O'Dwyer T
- Issue date: 2009 Apr
- Histopathological features of occult metastasis detected by sentinel lymph node biopsy in oral and oropharyngeal squamous cell carcinoma.
- Authors: Stoeckli SJ, Pfaltz M, Steinert H, Schmid S
- Issue date: 2002 Jan
- [Sentinel lymph node in oral and oropharyngeal epithelial tumors].
- Authors: Cizmarevic B, Zargi M
- Issue date: 2006 Mar
- The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck.
- Authors: Shoaib T, Soutar DS, MacDonald DG, Camilleri IG, Dunaway DJ, Gray HW, McCurrach GM, Bessent RG, MacLeod TI, Robertson AG
- Issue date: 2001 Jun 1