Sentinel node biopsy as an alternative to elective neck dissection for staging of early oral carcinoma

Head Neck. 2014 Feb;36(2):241-6. doi: 10.1002/hed.23288. Epub 2013 Jun 1.

Abstract

Background: We report the outcome of sentinel node biopsy (SNB) for staging the neck in a consecutive cohort of 34 patients with T1/2 clinically N0 oral carcinoma.

Methods: SNB was performed along with resection of primary tumor. Neck dissection was reserved for failure of SNB or pathologically positive sentinel nodes (pN+).

Results: Sentinel node identification was successful in 32 of 34 patients (94%); 2 patients with unsuccessful SNB underwent immediate neck dissection. Seven patients (21%) were pN+, 6 by SNB and 1 by elective neck dissection (END). Among 29 patients who were pN0 on SNB, nodal recurrence developed in 2 patients; both were surgically salvaged. Local failure developed in 1 patient. Two-year overall and disease-free survival was 87% and 80%, respectively.

Conclusion: Successful eradication of lymphatic metastasis noted in this study suggests that SNB may be a safe alternative to END for neck staging in patients with early oral carcinoma.

Keywords: elective neck dissection; oral cancer; sentinel node biopsy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / surgery*
  • Cohort Studies
  • Elective Surgical Procedures / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / surgery*
  • Neck Dissection* / methods
  • Neoplasm Staging
  • Sentinel Lymph Node Biopsy*
  • Survival Analysis