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

Authors


  • 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.

Abstract

Objectives/Hypothesis:

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

Study Design:

Prospective cohort study.

Methods:

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.

Results:

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%.

Conclusions:

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.

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