Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer

Schilling, Clare; Stoeckli, Sandro J.; Haerle, Stephan K.; Broglie, Martina A.; Huber, Gerhard; Sørensen, Jens Ahm; Bakholdt, Vivi; Krogdahl, Annelise; Buchwald, Christian von; Bilde, Anders; Sebbesen, Lars; Odell, Edward; Gurney, Ben; O’Doherty, Michael; Bree, Remco de; Bloemena, Elisabeth; Flach, Géke B.; Villarreal, Pedro; Forcelledo, Manuel Florentino Fresno; Gutiérrez, Luis; Amézaga, Julio Alvarez; Barbier, Luis; Santamaría-Zuazua, Joseba; Moreira, Augusto; Jacóme, Manuel; Vigili, Maurizio Giovanni; Rahimi, Siavash; Tartaglione, Girolamo; Lawson, Georges; Nollevaux, Marie-Cécile; Grandi, Cesare; Donner, Davide; Bragantini, Emma; Dequanter, Didier; Lothaire, Philippe; Poli, Tito; Silini, Enrico Maria; Sesenna, E.; Dolivet, G.; Mastronicola, Romina; Leroux, Agnès; Sassoon, Isabel; Sloan, Philip; McGurk, Mark

doi:10.1016/j.ejca.2015.08.023

Cited by 315 publications

(342 citation statements)

References 30 publications

Supporting

Mentioning

300

Contrasting

Unclassified

Order By: Relevance

“…After full text review, an additional 111 manuscripts were excluded (the reasons were presented on Fig 1). Finally, 66 studies fulfilled the inclusion criteria for the meta analysis, comprising 3566 patients [5, 10–12, 17–19, 21–79] (Fig 1). …”

Section: Resultsmentioning

confidence: 99%

“…Although some previous meta-analyses have conducted subgroup analysis on OSCC, the small included sample size was underpowered to yield credible pooled findings. In recent years, many high quality prospective and some multi-institutional studies on the diagnostic efficacy of SLNB in early OSCC have been published [17–19]. Therefore, we performed a meta-analysis to summarize the diagnostic efficacy of SLNB specially focused exclusively on early OSCC.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Efficacy of Sentinel Lymph Node Biopsy in Early Oral Squamous Cell Carcinoma: A Meta-Analysis of 66 Studies

et al. 2017

View full text Add to dashboard Cite

ObjectivesThe diagnostic efficacy of sentinel lymph node biopsy(SLNB) in early oral squamous cell carcinoma(OSCC) still remains controversial. This meta-analysis was conducted to assess the diagnostic value of SLNB in clinically neck-negative T1-2 OSCC.MethodsA systematic literature search for relevant literature published up to September 11, 2016 was conducted in PubMed, Embase, Web of Science, Cochrane Library and ClinicalTrials, and the reference lists of eligible studies were examined. Data from different studies were pooled to estimate the summary sentinel lymph node(SLN) identification rate, sensitivity, negative predictive value. Summary receiver operator characteristic curve(SROC) was plotted and area under the SROC curve (AUC) was calculated to evaluate the overall diagnostic efficacy. Threshold effect was assessed with use of the spearman correlation coefficient. Between-study heterogeneity was tested using the Q tests and the I2 statistics. Subgroup analyses were conducted in view of the greater effect of different study characteristics on diagnostic efficacy of SLN. Deeks’ funnel plot asymmetry test was performed to evaluate publication bias. Sensitivity analysis was evaluated through omitting studies one by one and comparing the pooled results of random-effects model and fixed-effects model. All analyses were performed using Review Manager (version 5.3.5), Meta-DiSc (version 1.4), Comprehensive Meta Analysis (version 2.0) and STATA (version 12).Results66 studies comprising 3566 patients with cT1-2N0 OSCC were included in this meta-analysis. The pooled SLN identification rate was 96.3%(95% CI: 95.3%-97.0%). The pooled sensitivity was 0.87 (95% CI: 0.85–0.89), pooled negative predictive value was 0.94 (95% CI: 0.93–0.95), and AUC was 0.98 (95% CI: 0.97–0.99). Subgroup analyses indicated that SLN assessment with immunohistochemistry(IHC) achieved a significantly higher sensitivity than without IHC.ConclusionsThis meta-analysis suggests that SLNB has a high diagnostic accuracy in cT1-2N0 oral squamous cell carcinoma, and is an ideal alternative to elective neck dissection. Furthermore, the use of IHC can significantly improve SLNB diagnostic sensitivity for early OSCC.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic Efficacy of Sentinel Lymph Node Biopsy in Early Oral Squamous Cell Carcinoma: A Meta-Analysis of 66 Studies

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In fact, the benefit of using the DTBC model may be similar to the benefit of using SNB at a low threshold probability of having lymph node metastases, but it requires a two-step procedure. It is also important to acknowledge that even SNB, apart from being both labor intensive and expensive, is not 100% accurate in predicting lymph node metastases [36]. A limitation of our study is that the DTBC needs to be performed on immunohistochemically stained surgical resection specimens, as it is not possible for the software to perform the analysis on standard H&E stained sections.…”

Section: Discussionmentioning

confidence: 99%

Construction of a pathological risk model of occult lymph node metastases for prognostication by semi-automated image analysis of tumor budding in early-stage oral squamous cell carcinoma

et al. 2017

Self Cite

View full text Add to dashboard Cite

It is challenging to identify at diagnosis those patients with early oral squamous cell carcinoma (OSCC), who have a poor prognosis and those that have a high risk of harboring occult lymph node metastases. The aim of this study was to develop a standardized and objective digital scoring method to evaluate the predictive value of tumor budding. We developed a semi-automated image-analysis algorithm, Digital Tumor Bud Count (DTBC), to evaluate tumor budding. The algorithm was tested in 222 consecutive patients with early-stage OSCC and major endpoints were overall (OS) and progression free survival (PFS). We subsequently constructed and cross-validated a binary logistic regression model and evaluated its clinical utility by decision curve analysis. A high DTBC was an independent predictor of both poor OS and PFS in a multivariate Cox regression model. The logistic regression model was able to identify patients with occult lymph node metastases with an area under the curve (AUC) of 0.83 (95% CI: 0.78–0.89, P <0.001) and a 10-fold cross-validated AUC of 0.79. Compared to other known histopathological risk factors, the DTBC had a higher diagnostic accuracy. The proposed, novel risk model could be used as a guide to identify patients who would benefit from an up-front neck dissection.

show abstract

“…[15][16][17][18][19][20][21][22][23][24][25] From 2005 to 2010, a prospective European Sentinel Node observational Trial (SENT) involving 14 European institutions was conducted to establish the role of SNB in the management of early OSCC. 26 Sentinel nodes were mapped using lymphoscintigraphy, requiring a multidisciplinary approach involving nuclear medicine physicians, surgeons, and pathologists in a variety of practice settings.…”

mentioning

confidence: 99%

Sentinel Node in Oral Cancer

Tartaglione

Stoeckli

Bree

et al. 2016

Clinical Nuclear Medicine

Self Cite

View full text Add to dashboard Cite

Purpose: Nuclear imaging plays a crucial role in lymphatic mapping of oral cancer. This evaluation represents a subanalysis of the original multicenter SENT trial data set, involving 434 patients with T1-T2, N0, and M0 oral squamous cell carcinoma. The impact of acquisition techniques, tracer injection timing relative to surgery, and causes of false-negative rate were assessed. Methods: Three to 24 hours before surgery, all patients received a dose of 99m Tc-nanocolloid (10-175 MBq), followed by lymphoscintigraphy. According to institutional protocols, all patients underwent preoperative dynamic/ static scan and/or SPECT/CT. Results: Lymphoscintigraphy identified 723 lymphatic basins. 1398 sentinel lymph nodes (SNs) were biopsied (3.2 SN per patient; range, 1-10). Dynamic scan allowed the differentiation of sentinel nodes from second tier lymph nodes. SPECT/CT allowed more accurate anatomical localization and estimated SN depth more efficiently. After pathological examination, 9.9% of the SN excised (138 of 1398 SNs) showed metastases. The first neck level (NL) containing SN+ was NL I in 28.6%, NL IIa in 44.8%, NL IIb in 2.8%, NL III in 17.1%, and NL IV in 6.7% of positive patients. Approximately 96% of positive SNs were localized in the first and second lymphatic basin visualized using lymphoscintigraphy. After neck dissection, the SN+ was the only lymph node containing metastasis in approximately 80% of patients. Conclusions: Best results were observed using a dynamic scan in combination with SPECT/CT. A shorter interval between tracer injection, imaging, and surgery resulted in a lower false-negative rate. At least 2 NLs have to be harvested, as this may increase the detection of lymphatic metastases.

show abstract

Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer

Cited by 315 publications

References 30 publications

Diagnostic Efficacy of Sentinel Lymph Node Biopsy in Early Oral Squamous Cell Carcinoma: A Meta-Analysis of 66 Studies

Diagnostic Efficacy of Sentinel Lymph Node Biopsy in Early Oral Squamous Cell Carcinoma: A Meta-Analysis of 66 Studies

Construction of a pathological risk model of occult lymph node metastases for prognostication by semi-automated image analysis of tumor budding in early-stage oral squamous cell carcinoma

Sentinel Node in Oral Cancer

Contact Info

Product

Resources

About