Sentinel Lymph Node Biopsy in Oral and Oropharyngeal Squamous Cell Carcinoma: Statistical Validation and Impact of Micrometastasis Involvement on the Neck Dissection Decision

The role of sentinel node biopsy in oral squamous cell carcinoma

“…After screening the titles and abstracts of the remaining 69 articles, applying the third selection (prospective studies, TxN0, 30 patients at least) we selected 12 articles. [12,[16][17][18][19][20][21][22][23][24][25][26] Together with two additional prospective articles [27,28] identified from reviews and references, a total of 14 articles were included in this systematic review. Table 1 summarizes all the studies included providing the details of the individual studies (full database available from author).…”

“…SN identification rates, as well as accuracy of staging of lymphatic spread, are comparable with those reported in melanoma and breast cancer, where this procedure is used routinely in patient care. [14][15][16] The purpose of this study was to conduct a systematic review of the published literature to assess the state of the art of this procedure focused on the role of the SNB in the OSCC. We have evaluated the advantages of SNB compared to ND and its limitations, testing different solutions and innovations that could implement the conventional Farmer et al [17] Flach et al [18] Alvarez et al [21] Ross e t al.…”

MR lymphography for sentinel lymph node detection in patients with oral cavity cancer: Preliminary clinical study

“…Cervical lymph node metastasis is the single most important prognostic factor in oral cavity squamous cell carcinoma, and accurate detection of cervical lymph node metastases is critical for surgical and adjuvant therapy planning and prognosis prediction . However, currently available imaging techniques are not sufficiently sensitive to detect cervical lymph node metastases, resulting in high incidence rates (20%‐60%) of occult metastases . Therefore, elective neck dissection, which is the standard treatment in patients with oral cavity cancer and clinically negative neck, is effective in only 20%‐60% of patients with occult lymph node metastases, with the remaining 40%‐80% requiring avoidable surgery that results in high morbidity and costs.…”

“…Several studies have validated the accuracy and efficacy of sentinel lymph node biopsy in patients with oral cavity cancer, and reported its high sensitivity and negative predictive value, which results in lower morbidity and costs relative to elective neck dissection. [2][3][4][5][6] Accordingly, in institutions where it is available, sentinel lymph node biopsy is considered a viable alternative to elective neck dissection for the identification of occult cervical metastasis in patients with early oral cavity cancer, in accordance with the 2017 National Comprehensive Cancer Network Clinical Practice Guidelines. 7 An MR lymphography is a technique that uses MRI after interstitial injection of extracellular gadolinium chelates to identify sentinel lymph nodes.…”

Sentinel Lymph Node Biopsy: A new approach in the management of head and neck cancers

“…33 The techniques and methodology for SLN identification in head and neck cancers have been widely debated and are still under investigation [ Tables 1 and 2]. 5,14,15,22,24,[27][28][29][30][31][34][35][36][37][38][39][40][41][42][43][44][45][46] Shoaib et al suggested a protocol involving preoperative lymphoscintigraphy, intraoperative blue dye and gamma probe localisation [ Figure 2]. 30 This technique is based on observing the route of lymphatic flow via imaging after the injection of a radioactive contrast agent near the primary tumour.…”