The prevalence of occult metastases in nonsentinel lymph nodes after step‐serial sectioning and immunohistochemistry in cN0 oral squamous cell carcinoma

Abstract

The incidence of occult metastases in NSN after additional SSS and IHC was 2%. The risk of NSN involvement would seem to be extremely low in patients with early OSCC and negative SN. This study further validates SNB as an accurate staging tool for cN0 early OSCC.

Use of a Novel Receptor-Targeted (CD206) Radiotracer,99mTc-Tilmanocept, and SPECT/CT for Sentinel Lymph Node Detection in Oral Cavity Squamous Cell Carcinoma

“…In the absence of a prospective study, it would be premature and inappropriate to suggest therapeutic potential for SLNB alone in OSCC on the basis of such findings, especially because the non-SLNs in this and most prior studies have not been subjected to the same degree of histologic scrutiny. Nonetheless, this finding is consistent with previous reports by others 13 and seems to support the ability of 99m Tc-tilmanocept to achieve accurate SLN mapping and correctly identify anatomic metastatic pathways for a disease entity with substantial potential for unpredictable behavior due to factors including variable lymphatic drainage pattern and occurrence of “skip” metastases. Furthermore, such findings indicate aspects of tumor behavior that may not be adequately encompassed by empirical END carried out in the absence of preoperative LS and/or SLNB procedures.…”

“…Other studies, however, have examined non-SLNs such as those obtained via END using such detailed methods, identifying the rate of occult disease in non-SLNs to be quite low (2%). 13 Such methodology obviously also poses a substantial practical issue, and thus in the absence of established efficacy, routine use of similar detailed measures for non-SLNs becomes difficult to justify.…”

Staging of early lymph node metastases with the sentinel lymph node technique and predictive factors in T1/T2 oral cavity cancer: A retrospective single‐center study

“…This discrepancy in sensitivity could be explained by the following mechanism: the excised lymph nodes from a neck dissection are not examined using step‐serial sectioning, and small metastases may therefore have been missed. We have, however, previously examined non‐SLNs in an SLNB cohort using step‐serial sectioning and found the prevalence of missed metastases to be very low . Another, more likely explanation is that the drainage of the primary tumor was unexpected and that the metastases would therefore not have been harvested during a “standard” neck dissection.…”

Detection of Cervical Lymph Node Micrometastases in Patients with Squamous Cell Carcinoma of the Oral Cavity, Pharynx and Larynx

“…Many authors in recent years have focused on detection of HNSCC micrometastases using immunohistochemical methods. Positive results in patients with clinical N0 stage varies widely from 2 to 58% (13)(14)(15)(16)(17)(18), which indicates that the methods for detection are not united and the percentage of positive results depends on the experience of the pathologist. In our study, micrometastases or ITC were detected in 5 cases (42%), 4 patients (33%) had a metastases of SCC and 1 patient (9%) had an accidental finding of PTC micrometastasis.…”