Prognostic study of sentinel lymph node biopsy in early-stage oral squamous cell carcinoma with computed tomography lymphography

Kenichiro Uchida; Yoshiya Ueyama; Ryo Nonaka; Kento Noda; Jyunichi Misumi; Katsuaki Mishima

doi:10.1016/j.jormas.2023.101723

Prognostic study of sentinel lymph node biopsy in early-stage oral squamous cell carcinoma with computed tomography lymphography

J Stomatol Oral Maxillofac Surg. 2023 Dec 2;125(4):101723. doi: 10.1016/j.jormas.2023.101723. Online ahead of print.

Authors

Kenichiro Uchida¹, Yoshiya Ueyama², Ryo Nonaka², Kento Noda², Jyunichi Misumi², Katsuaki Mishima²

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan. Electronic address: k.uchida@yamaguchi-u.ac.jp.
² Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.

PMID: 38048906
DOI: 10.1016/j.jormas.2023.101723

Abstract

Purpose: Occult metastasis is a prognostic factor for early-stage oral squamous cell carcinoma (OSCC). Sentinel lymph node (SLN) biopsy (SLNB) is a promising method to detect such metastases. The present study aimed to evaluate the diagnostic reliability of SLNB with computed tomography lymphography (CTL) for early-stage OSCC and to clarify patient outcomes after SLNB.

Methods: The medical records of 42 patients with T1 or T2 cN0 OSCC who had undergone CTL the day before surgery were retrospectively collected and statistically analyzed.

Results: SLNs were identified on CTL in 41 of 42 OSCC patients (97.6 %). Micrometastases were detected in 10 of 41 cases (24.4 %) and 11 of 65 SLNs (16.9 %) by intraoperative pathological diagnosis. Three cases showed occult metastasis within a year after the primary operation. Specificity and negative predictive value were 76.9 % and 90.3 %, respectively. The cumulative 5-year regional recurrence-free rate was 89.7 % in 31 SLNB-negative patients. Five-year overall and disease-free survival rates were 86.9 % and 70.1 %, respectively, in the 41 cases with identified SLNs.

Conclusion: CTL offers acceptable results and appears likely to be effective in treating early-stage OSCC patients with low-invasive surgery. Further investigation is necessary to compare radioisotope-based methods.

Keywords: Cervical metastasis; Computed tomography lymphography; Oral squamous cell carcinoma; Sentinel lymph node biopsy.