Function, postoperative morbidity, and quality of life after cervical sentinel node biopsy and after selective neck dissection

Schiefke, Franziska; Akdemir, Michael; Weber, Anette; Akdemir, Daniel; Schnittger, Susanne; Frerich, Bernhard

doi:10.1002/hed.21001

Cited by 187 publications

(177 citation statements)

References 46 publications

(49 reference statements)

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“…Thus, SNB reduced the rate of secondary neck metastasis and increased the 5-year OS rate. Other studies reported a 5-year OS rate of 80% and a 2-year OS rate of 87-90%; our results are superior to those findings (3,18,20,21), suggesting that SNB is an effective approach in cN0 early OSCC. However, there have been few previous reports comparing excision alone to excision with SNB.…”

Section: Discussioncontrasting

confidence: 95%

“…In other reports, the NPV and false-negative rates were 90-96 and 2.5-22%, respectively (3,10,18,20,21). In the present study, the NPV and false-negative rates were 94 and 18%, respectively, which were similar to previously reported rates.…”

Section: Discussionsupporting

confidence: 91%

“…In this respect, our findings were similar to those of other studies reporting that postoperative complications of neck dissection, such as neck hematoma, facial palsy, postoperative infection and limited range of motion in the arm, rarely occur after SNB (20).…”

Section: Discussionsupporting

confidence: 91%

“…Other reports have demonstrated that secondary neck metastasis occurred in 0-6% of cases that underwent SNB, and our results were similar (3,18,20,21).…”

Section: Discussionsupporting

confidence: 89%

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Sentinel lymph node biopsy reduces the incidence of secondary neck metastasis in patients with oral squamous cell carcinoma

Hiraki

Fukuma

Nagata

et al. 2016

Molecular and Clinical Oncology

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Abstract. It has recently been established that sentinel node biopsy (SNB) is an applicable and feasible procedure for the prediction of neck lymph node status in patients with early oral squamous cell carcinoma (OSCC) who are clinically negative for neck metastasis (cN0). The aim of this study was to retrospectively compare excision followed by watchful waiting with excision and SNB, in order to determine the effectiveness of SNB. A total of 125 patients with cN0 early OSCC were divided into two groups, namely the excision alone (n=78) and excision with SNB (n=47) groups. The clinical data of these two groups between 2006 and 2013 were analyzed. In the excision with SNB group, the negative predictive value and false-negative rate of SNB were 94% (30̸32) and 18% (2̸11), respectively. Secondary neck metastasis, also known as delayed neck metastasis, occurred in 24.2% of the patients in the excision alone group and 4.9% of the patients in the excision with SNB group. The 5-year overall survival (OS) rates were 84.0 and 97.5% in the excision alone and excision with SNB groups, respectively. Significant differences were found in the rate of secondary neck metastasis and OS between the two groups. SNB may be effective in the detection of occult neck lymph node metastasis, with a reduction in the incidence of secondary neck metastasis and improvements in the 5-year OS in patients with early-stage (stage I̸II) oral cancer. IntroductionThe status of lymph nodes in the neck is the most important prognostic factor for oral squamous cell carcinoma (OSCC). The rate of secondary neck metastases of OSSC is ~20-30% (1-6). Even with advanced modern imaging techniques, including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US) and fluorodeoxyglucose positron emission tomography (FDG-PET), the accuracy of current diagnostic imaging does not exceed 80% (2).The treatment strategies for early-stage oral cancer clinically negative for neck metastasis (cN0) include performing elective neck dissection (END) or opting for the watchful waiting approach. END is currently the standard treatment for patients in the absence of positive lymph nodes on imaging tests. Some reports recommend END, as it reduces the risk of uncontrolled disease (2,3). Furthermore, a recent meta-analysis of randomized controlled trials suggested a survival advantage with END (7). However, ≤70% of patients undergo unnecessary neck dissection, resulting in decreased quality of life (8,9).Therefore, accurate detection of occult metastases is crucial, as it allows for appropriate treatment planning.With respect to sentinel node biopsy (SNB) in oral cancer, large multi-institutional clinical trials have been conducted (10,11) and numerous studies have demonstrated that SNB is associated with predictably high accuracy in identifying occult metastasis (10,12).The objective of this study was to determine the benefits of SNB for cN0 disease. We retrospectively compared long-term survival following excision alone or excision and SNB in patients wit...

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

“…Other reports have demonstrated that secondary neck metastasis occurred in 0-6% of cases that underwent SNB, and our results were similar (3,18,20,21).…”

Section: Discussionsupporting

confidence: 89%

See 2 more Smart Citations

Sentinel lymph node biopsy reduces the incidence of secondary neck metastasis in patients with oral squamous cell carcinoma

Hiraki

Fukuma

Nagata

et al. 2016

Molecular and Clinical Oncology

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“…However, the main pitfall of this strategy is that histopathological diagnosis based on serial sections with immunohistochemistry (SS-IHC) is far too time consuming to be made use of during surgery in routine practice (van Diest et al, 2001). A delayed pN diagnosis compels pN þ patients (up to 40% of cases) to undergo further additional surgery with an increased risk of post-operative complications and a damaged functional outcome (Kuntz and Weymuller, 1999;Schiefke et al, 2009). In this context, real-time reverse transcriptase-PCR (RT -PCR) may be helpful because it is operator independent and, with some adaptation, can be automated and rapidly performed (Raja et al, 2002;Hamakawa et al, 2004).…”

mentioning

confidence: 99%

Pemphigus vulgaris antigen mRNA quantification for the staging of sentinel lymph nodes in head and neck cancer

et al. 2009

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BACKGROUND: Molecular diagnosis has been proposed to enhance the intra-operative diagnosis of sentinel lymph node (SLN) invasion in head and neck squamous cell carcinoma (HNSCC). Although cytokeratin (CK) mRNA quantification with real-time reverse transcriptase-PCR (QRT -PCR) has produced encouraging results, the more discriminating markers remain to be identified. METHODS: Pemphigus vulgaris antigen (PVA), squamous cell carcinoma antigen (SCCA), and CK17 mRNA were quantified using QRT -PCR, and the results were compared with an extensive histopathological examination of the entire SLNs on 78 SLNs harvested from 22 patients with HNSCC. RESULTS: SCCA and CK17 quantification showed significantly higher mRNA values for macrometastases (MAs) than for either negative or isolated tumour cell (ITC) SLNs (Po0.01). Pemphigus vulgaris antigen allowed the discrimination of all MAs and micrometastases from both negative and ITC SLNs (Po0.001). For the neck staging of patients, considering metastatic vs non-metastatic status, receiver-operating characteristic curve analysis found areas under the curve of 93.8, 97.9, and 100% for CK17, SCCA, and PVA, respectively. With PVA, a cutoff value of 562 copies per 100 ng of cDNA permitted the correct distinction between patients with positive as opposed to negative neck nodes in all cases. CONCLUSION: PVA seems to be a highly promising marker for accurate intra-operative SLN staging in HNSCC by QRT -PCR.

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Sentinel Node Biopsy in Lieu of Neck Dissection for Staging Oral Cancer

Rigual

Loree

Frustino

et al. 2013

JAMA Otolaryngol Head Neck Surg

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Function, postoperative morbidity, and quality of life after cervical sentinel node biopsy and after selective neck dissection

Abstract: Functional outcome after SNB is significantly better than after SND; however, this is not reflected in the scores of QOL questionnaires.

Cited by 187 publications

References 46 publications

Sentinel lymph node biopsy reduces the incidence of secondary neck metastasis in patients with oral squamous cell carcinoma

Sentinel lymph node biopsy reduces the incidence of secondary neck metastasis in patients with oral squamous cell carcinoma

Pemphigus vulgaris antigen mRNA quantification for the staging of sentinel lymph nodes in head and neck cancer

Sentinel Node Biopsy in Lieu of Neck Dissection for Staging Oral Cancer

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