Efficacy of different sentinel lymph node biopsy protocols in oral squamous cell carcinoma: Systematic review and meta-analysis

Head Neck. 2022 Jul;44(7):1702-1714. doi: 10.1002/hed.27042. Epub 2022 Mar 31.

Abstract

The sentinel node biopsy (SNB) is highly protocolized in other cancers, however, this is not the case for oral squamous cell carcinoma patients, hence our objective was to evaluate the different protocols published. A specific study protocol was designed and subsequently registered on PROSPERO (Ref. CRD42021279217). Twenty-three articles were included in the meta-analysis. The grouped sensitivity of the SNB was 82% (95% CI: 0.74-0.88), and the grouped specificity was 100% (95% CI: 0.99-1.00). The use of other radiotracers other than pre-operative lopamidol showed higher values of sensitivity of 82.80% (95% CI: 76.90%-87.50%; p < 0.001). The use of the blue dye stain showed higher sensitivity values of 85.60% (95% CI: 71.90%-93.20%), compared to sensitivity values of 77.50% when it was not used (95% CI: 69.10%-84.20%) (p < 0.001). Diagnostic rates are variable and they were significantly better when 99mTc was used in all its variations and accompanied by the blue dye staining.

Keywords: blue dye; indocyanine green; protocols; sentinel node lymph biopsy; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Clinical Protocols
  • Coloring Agents
  • Humans
  • Indocyanine Green
  • Lymph Nodes* / pathology
  • Mouth Neoplasms* / diagnosis
  • Mouth Neoplasms* / pathology
  • Sentinel Lymph Node Biopsy*
  • Squamous Cell Carcinoma of Head and Neck* / diagnosis
  • Squamous Cell Carcinoma of Head and Neck* / pathology

Substances

  • Coloring Agents
  • Indocyanine Green