Premium
Sentinel node biopsy in early oral squamous cell carcinomas: A 10‐year experience
Author(s) -
Melkane Antoine E.,
Mamelle Gérard,
Wycisk Gregory,
Temam Stéphane,
Janot François,
Casiraghi Odile,
Lumbroso Jean
Publication year - 2012
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.23383
Subject(s) - medicine , sentinel node , biopsy , micrometastasis , prospective cohort study , tongue , lymphovascular invasion , stage (stratigraphy) , cohort , radiology , pathology , cancer , metastasis , breast cancer , paleontology , biology
Objectives/Hypothesis: To evaluate the reliability of the sentinel node (SN) biopsy in early oral squamous cell carcinomas. Study Design: Prospective cohort study. Methods: We conducted a primary prospective study on 53 consecutive patients presenting T1, T2 N0 squamous cell carcinomas of the oral cavity between January 2000 and June 2003. Primary results demonstrated a negative predictive value of 100%. The series was then extended until June 2010, with a total number of 166 successful procedures. Results: The cohort accounted for 118 males and 48 females with a mean age of 56 years. The median follow‐up period was 36 months. There were 42 patients (25%) with positive SNs, 14 of them (33%) only harboring micrometastasis. The negative predictive value of the sentinel node biopsy was 95.2%. The SN involvement was strongly correlated with the tumor location (34% of SN+ for the tongue vs. 13% for the floor of mouth, P = .003), tumor stage (18% of SN+ for T1 vs. 40% for T2, P = .002), depth of invasion (median depth for SN+ lesions was 6.5 mm vs. 4 mm for SN− lesions, P = .028), and lymphovascular involvement ( P = .002). The false‐negative rate of frozen section examination was 42%. Conclusions: The sentinel node biopsy appears to be an excellent staging method in early oral cancers. This study also provides evidence that routinely undiagnosed micrometastasis may have clinical significance.