Sentinel node biopsy in early oral squamous cell carcinomas: A 10-year experience


  • This study was conducted entirely in the Gustave Roussy Institute, Villejuif, France.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.



To evaluate the reliability of the sentinel node (SN) biopsy in early oral squamous cell carcinomas.

Study Design:

Prospective cohort study.


We conducted a primary prospective study on 53 consecutive patients presenting T1, T2 N0 squamous cell carcinomas of the oral cavity between January 2000 and June 2003. Primary results demonstrated a negative predictive value of 100%. The series was then extended until June 2010, with a total number of 166 successful procedures.


The cohort accounted for 118 males and 48 females with a mean age of 56 years. The median follow-up period was 36 months. There were 42 patients (25%) with positive SNs, 14 of them (33%) only harboring micrometastasis. The negative predictive value of the sentinel node biopsy was 95.2%. The SN involvement was strongly correlated with the tumor location (34% of SN+ for the tongue vs. 13% for the floor of mouth, P = .003), tumor stage (18% of SN+ for T1 vs. 40% for T2, P = .002), depth of invasion (median depth for SN+ lesions was 6.5 mm vs. 4 mm for SN− lesions, P = .028), and lymphovascular involvement (P = .002). The false-negative rate of frozen section examination was 42%.


The sentinel node biopsy appears to be an excellent staging method in early oral cancers. This study also provides evidence that routinely undiagnosed micrometastasis may have clinical significance.