Outcome of sentinel lymph node biopsy in early-stage squamous cell carcinoma of the oral cavity with methylene blue dye alone: a prospective validation study

Vishnoi, Jeewan Ram; Kumar, Vijay; Gupta, Sudeep; Chaturvedi, Arun; Misra, Sanjeev; Akhtar, Naseem; Agarwal, Preeti; Jamal, Naseem; Pareek, Puneet

doi:10.1016/j.bjoms.2019.06.025

Cited by 22 publications

(17 citation statements)

References 23 publications

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“…Two authors individually collected data from included articles in forms commensurate with each other. Diagnostic accuracy, represented by DOR, summary receiver operating characteristic (SROC) curve, and area under the curve (AUC), was calculated 1,5,11–102 . DOR was calculated as (true positive [TP]/false positive [FP])/(false negative [FN]/true negative [TN]) to assess diagnostic accuracy with 95% confidence intervals (CIs).…”

Section: Methodsmentioning

confidence: 99%

Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta‐Analysis

Kim

et al. 2020

The Laryngoscope

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Objective We assessed the diagnostic accuracy of sentinel lymph node biopsy (SLNB) for detecting neck nodal metastasis in early oral squamous cell carcinoma (OSCC) as an alternative to elective neck dissection. Study Design A systematic search for relevant literature was conducted in the PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases. Methods Two reviewers individually searched the five databases up to November 2019. For studies that met inclusion criteria, data on patient diagnoses were pooled, including true positives, true negatives, false positives, and false negatives. Methodological quality was checked with the Quality Assessment of Diagnostic Accuracy Studies (version 2) tool. Results In total, 98 observational or retrospective studies were included. The diagnostic odds ratio of SLNB was 326.165 (95% confidence interval [CI]: 231.477–459.587; I2 = 0%). The area under the summary receiver operating characteristic curve was 0.982. Sensitivity was 0.827 (95% CI: 0.804–0.848), and specificity was 0.981 (95% CI: 0.975–0.986). The correlation between sensitivity and the false positive rate was −0.076, which indicates that heterogeneity did not exist. Subgroup analyses were performed with the subgroups reference test type, publication year, and study type. No significant difference was found within the reference test type subgroup. However, differences within the publication year and study type subgroups were significant, where the retrospective study subgroup was significantly more sensitive and specific than the prospective study subgroup. Conclusion Results of this meta‐analysis imply that the high specificity of SLNB supports its role as a diagnostic tool for patients with clinical tumor stage (CT)1‐2 clinically negative (N0) OSCC. More studies should be done to further verify the results of this study. Level of Evidence 2a Laryngoscope, 131:E459–E465, 2021

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Section: Methodsmentioning

confidence: 99%

Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta‐Analysis

Kim

et al. 2020

The Laryngoscope

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“…The identification of radioactive colloid accumulation within sentinel lymph node using a gamma ray counter supports neck node dissection in patients with nodal negative early OCC [46,47]. Interestingly, a detection of sentinel lymph node using methylene blue dye alone has been proposed in developing countries due to their limited availability of lymphoscintigraphic facilities [48]. Methylene blue dye is effective, low cost, easily available and with a good safety profile [49] (Figure 2).…”

Section: Treatment Opportunitiesmentioning

confidence: 99%

“…The largest study of sentinel node biopsy in early OCC included 94 patients (75 men and 19 women, with a median age of 45 years) with cT1-2 cN0 disease [48]. This prospective study was conducted in a large tertiary care cancer centre in India.…”

Section: Treatment Opportunitiesmentioning

confidence: 99%

“…Lymph nodes metastasis were described in level IB (48.6%), IIA (37.1%), III (8.6%) and IA (5.7%). Results showed a good sensitivity (84.6%) and negative predictive value (93.9%) of the procedure and defined immunohistochemistry as the preferable technique to detect micrometastasis within lymph nodes [48]. The main limitation is the blue dye spillage in tissue planes, even though one-millimeter injection seems to reduce spillage while still maintaining an oncologic adequate result.…”

Section: Treatment Opportunitiesmentioning

confidence: 99%

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Nanotechnology in Oral Cavity Carcinoma: Recent Trends and Treatment Opportunities

et al. 2019

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Oral cavity carcinoma (OCC) remains an ongoing public health problem. Emerging nanotechnology provides alternative treatment approaches. This review covers the up-to-date literature in the human OCC treatment field. We explored the growing body of evidence to reveal novel and highly promising diagnostic and therapeutic applications of nanotechnology in this field. Various types of nanoparticles have been tested for applications in OCC. Imaging modalities in addition to nanocarriers are discussed. The encouraging contribution of lymphotropic nanoparticles contrast in the diagnosis of metastatic cervical lymph nodes needs to be confirmed. The development of the sentinel lymph node procedure and photodynamic therapy may lead to breakthrough therapies in order improve clinical outcomes and quality of life. In this perspective, cancer nanotechnology has the potential to revolutionize the treatment of OCC patients.

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“…The gold standard in SLN mapping employs dual tracer techniques involving a combination of radioisotopes, blue dyes and/or fluorescence to increase reliability [4][5][6] . However, in specific countries and facilities, methylene blue dye is used alone for SLN mapping in light of its cost effectiveness, accessibility and safe outcomes 4,7,8 . Methylene blue is a non-specific blue dye with a good safety profile and has been described for use as an alternative to isosulfan blue and patent blue dye 2,4,9 .…”

Section: Introductionmentioning

confidence: 99%

Validating a semi-quantitative method to assess the degree of methylene blue staining in sentinel lymph nodes

Ram

Oblak

Matuszewska

et al. 2020

Preprint

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Validating a semi-quantitative method for assessment of degree of methylene blue staining in sentinel lymph nodes Abstract Purpose: To develop a digital algorithm and validate a semi-quantitative scoring method for surface methylene blue (MB) staining in whole lymph nodes (LN). Methods: Lymph nodes from canine models undergoing sentinel lymph node (SLN) mapping were prospectively assessed ex vivo and photographed. Two blinded observers evaluated all images and assigned a score based on surface staining (0 -no blue stain, 1 -1-50% stained, 2 -51-100% stained). A standard reference for degree of blue staining was based on signal-tobackground ratios using computer-based imaging software with an output measurement of percentage of staining of the LN. Agreement between observers was assessed using the Kappa coefficient. Results: 124 lymph nodes were included and demonstrated strong agreement (K = 0.8007, p < 0.0001) between results of semi-quantitative scoring and image analysis. Also, strong interobserver and intraobserver agreement was observed for the scoring system (K = 0.8051, p < 0.0001 and K = 0.9493, p < 0.0001, respectively). Discussion: Agreement between scoring system and imaging software illustrates a validated method in assessing MB staining, without the need for analysis software. The use of a semiquantitative scoring system shows promise for a simple, objective assessment of MB staining in surgery and for future study. Lymph nodes can have variable surface colour, which can make assessment of blue staining challenging for novice observers in certain cases. This study describes a digital algorithm for quantitative analysis of blue staining in LN thereby providing a novel and objective reporting mechanism in scientific research involving SLN mapping.

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Outcome of sentinel lymph node biopsy in early-stage squamous cell carcinoma of the oral cavity with methylene blue dye alone: a prospective validation study

Cited by 22 publications

References 23 publications

Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta‐Analysis

Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta‐Analysis

Nanotechnology in Oral Cavity Carcinoma: Recent Trends and Treatment Opportunities

Validating a semi-quantitative method to assess the degree of methylene blue staining in sentinel lymph nodes

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