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Long-Term Experience in Sentinel Node Biopsy for Early Oral and Oropharyngeal Squamous Cell Carcinoma

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

Long-term results of sentinel node biopsy (SNB) in early (T1/T2) oral and oropharyngeal squamous cell carcinoma (OSCC) in a single-institution experience.

Methods

Prospective consecutive cohort analysis of 79 patients (67% male, median age 60 years, age range 34–87 years) included between 2000 and 2006. Lymphatic mapping consisted of preoperative lymphoscintigraphy, single photon emission computed tomography (SPECT/CT), and intraoperative use of a handheld gamma probe. Endpoints of the study were neck control rate, overall (OS), disease-specific (DSS), and disease-free survival (DFS).

Results

Twenty-nine of 79 patients (37%) had positive sentinel nodes (SN). Six of 29 (21%) patients showed isolated tumor cells, 14/29 (48%) micrometastases, and 9/29 (31%) macrometastases. OS, DFS, and DSS at 5 years for the entire cohort were 80, 85, and 87%, for SN-negative patients were 88, 96, and 96%, and for SN-positive patients were 74, 73, and 77%, respectively. Only the difference in DSS achieved statistical significance. The neck control rate after 5 years was 96% in SN-negative and 74% in SN-positive patients. This difference was statistically significant.

Conclusions

SNB is a safe and accurate staging modality to select patients with clinically stage I/II OSCC with occult lymph node disease for elective neck dissection (END). The promising reported short-term results have been sustained by long-term follow-up. Patients with negative SN and no END achieve an excellent neck control rate which compares favorably with reports on primary END. The neck control rate in SN-negative patients is superior to that in SN-positive patients, which is reflected in superior DSS.

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland

    Martina A. Broglie MD & Sandro J. Stoeckli MD

  2. Clinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland

    Sarah R. Haile PhD

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  1. Martina A. Broglie MD
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  2. Sarah R. Haile PhD
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  3. Sandro J. Stoeckli MD
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Correspondence to Sandro J. Stoeckli MD.

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Broglie, M.A., Haile, S.R. & Stoeckli, S.J. Long-Term Experience in Sentinel Node Biopsy for Early Oral and Oropharyngeal Squamous Cell Carcinoma. Ann Surg Oncol 18, 2732–2738 (2011). https://doi.org/10.1245/s10434-011-1780-6

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  • DOI: https://doi.org/10.1245/s10434-011-1780-6

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