Sentinel Lymph Node Biopsy Versus Elective Neck Dissection: Long-Term Oncologic Outcomes in Clinically Node-Negative Tongue Cancer

Abstract

Objectives. To compare the long-term oncologic outcomes of sentinel lymph node biopsy (SLNB) versus elective neck dissection (END) in clinically node-negative (cN0) tongue cancer.Methods. This is a retrospective cohort study of patients with cN0 tongue cancer from a single institution, including 91 patients in the SLNB group and 120 patients in the END group. Results. Overall recurrence rate was no significant difference in the recurrence rate between the two groups. The regional control rate was also comparable between the two groups (p = 0.49). The 5-year RFS was slightly better in the SLNB group (p = 0.427). The 5-year OS was 89.9% in the SLNB group vs. 91.9% in the END group (p = 0.737). In propensity-matched subgroup analysis, the type of neck management did not affect RFS nor OS.Conclusions. SLNB showed non-inferior oncologic outcomes compared to END in patients with cN0 tongue squamous cell carcinoma.

Sentinel Lymph Node Biopsy Versus Elective Node Dissection in Stage cT1‐2N0 Oral Cavity Cancer

“…14 Each Kaplan-Meier curve was reconstructed using the DigitizeIt software (http:// www.digitizeit.de/), and the data points generated were subsequently used to calculate the HR using previously published methods. 33,34 For the study by Park et al, 22 data from 2007 onward were used because only then did the institution perform SNB alone versus END for cN0 neck management. Garrel et al 17 reported both neck node recurrence-free survival and locoregional recurrence-free survival Kaplan-Meier curves, 17 so the locoregional recurrence-free survival was incorporated into the DFS analysis.…”

“…We used Meta-Essentials to test publication bias (Erasmus Research Institute, Rotterdam, the Netherlands). 35 There were five retrospective studies included in the analysis, [14][15][16]20,22 which all have an inherent risk of bias in selection of participants based on methods for exclusion of patients.…”

“…There were 10 studies included in our analysis, published between 2014 and 2021, with sample sizes ranging from 70 to 8328 patients diagnosed with cT1-T2N0 OCSCC. [14][15][16][17][18][19][20][21][22][23] The total cohort contained 10,498 patients with 1,396 in the SNB group and 9,102 in the END group. Study characteristics are summarized in Table II.…”

Centralised pathology service for sentinel node biopsy in oral cavity cancer: The Southeast England Consortium experience

“…26,27 A FNR of 6.8% with a neck recurrence of 2.3% also compares favourably to single and multicentre studies. 5,11,26 A possible reason to explain increased sensitivity and NPV in our study is the utilisation of serial step sections with immunohistochemistry, a method known to increase the sensitivity of SLNB. 26 However, as a counterargument and as a limitation of this study, this sensitivity and NPV values may reflect the relatively small sample and immature follow-up period of our cohort.…”

“…Recent years have seen a growing body of evidence to indicate that SNLB, with completion neck dissection where necessary, has similar patient survival outcomes as END for the management of the N0 neck in early stage OSCC. [8][9][10][11]20 Furthermore, cost and quality of life analyses appear to favour SNLB over END in these patients. 12,21,22 Given these observations, several authorities recommend SLNB as the standard of care in cT1-2 N0 OSCC, while some professional bodies recommend that all patients with this disease should have access to the procedure.…”