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Sentinel lymph node biopsy versus elective neck dissection in squamous cell carcinoma of the oral cavity with a clinically N0 neck: Systematic review and meta‐analysis of prospective studies
Author(s) -
Ding Zhangfan,
Li Yike,
Pan Xun,
Xuan Ming,
Xie Huixu,
Wang Xiaoyi
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26803
Subject(s) - medicine , neck dissection , sentinel lymph node , confidence interval , biopsy , adverse effect , meta analysis , surgery , relative risk , prospective cohort study , carcinoma , radiology , cancer , breast cancer
Sentinel lymph node biopsy (SLNB) is an emerging strategy for managing early‐stage oral squamous cell carcinoma (SCC) with a clinically N0 (cN0) neck. However, the role of SLNB in this scenario is debatable. Herein, relevant literature was systematically reviewed, and a meta‐analysis was performed to evaluate the potential dividends of SLNB compared to elective neck dissection (END) for these patients. The meta‐analysis, including six prospective studies, showed comparable results of the two management strategies in terms of regional recurrence (risk ratio [RR] = 0.99; 95% confidence interval [CI], 0.58–1.70), 5‐year disease‐free survival (RR = 0.99; 95% CI, 0.87–1.11), and 5‐year overall survival (RR = 1.01; 95% CI, 0.90–1.13). Fewer adverse events occurred in the SLNB arm than in the END arm (RR = 0.12; 95% CI, 0.02–0.70). Overall, SLNB results in as favorable an oncologic prognosis for patients with cN0 oral SCC as END, while significantly lessening side effects and unnecessary surgeries.