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Positive Sentinel Lymph Nodes are a Negative Prognostic Factor for Survival in T1-2 Oral/Oropharyngeal Cancer—A Long-Term Study on 103 Patients

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

Abstract

Background

To evaluate prognostic value of sentinel node biopsy (SNB) in oral/oropharyngeal squamous cell cancer (OOSCC) concerning overall/disease-free survival.

Methods

One hundred three consecutive patients with T1-2N0 OOSCC were consecutively recruited for SNB as single invasive staging method for the neck. Two hundred seventy-three sentinel nodes (SNs) were removed (mean, 2.65 per patient). Nine patients had 10 positive SNs (upstaging rate, 8.7%) found in levels I to III, leading to a therapeutic neck dissection.

Results

Mean observation time of all patients was 6.7 years; mean survival time of patients with negative or positive SNs was 6.9 and 3.7 years, respectively. There has been no false-negative result of SNB to date becoming manifest in ipsilateral node metastasis during follow-up. Five-year overall/disease-free survival of all patients was 82%/72%, respectively. The same parameters for the patients with negative SNs were 85%/74%, for those with positive SNs 38%/47%, respectively (statistically significant). There has been a higher statistical risk for locoregional recurrence for patients with positive SNs. Rates of metachronous second primary tumors developing during follow-up were 10.6% (negative SNs) and 44.4% (positive SNs).

Conclusion

SNB was a valuable diagnostic method in patients with T1-2N0 OOSCC avoiding elective neck dissections. Patients with positive SNs had statistically significantly higher rates of locoregional recurrences, second primary tumors, tumor-related deaths, and a worse overall/disease-free survival. To date, no therapeutic consequences in case of a positive SN beyond execution of modified radical neck dissection (to remove other positive nodes) and closer attention during follow-up can be concluded from this study.

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Authors and Affiliations

  1. Department of Oral and Cranio-Maxillofacial Plastic Surgery, Johann Wolfgang Goethe University Medical School, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Adorján F. Kovács MD, DMD, PhD, Oliver Seitz MD & Robert Sader MD, DMD, PhD

  2. Ulrich Stefenelli, Services-in-Statistics, Untere Bockgasse 5, 97070, Würzburg, Germany

    Ulrich Stefenelli

  3. Department of Nuclear Medicine, Johann Wolfgang Goethe University Medical School, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Marcus Middendorp MD, Jürgen Diener & Frank Grünwald MD, PhD

Authors
  1. Adorján F. Kovács MD, DMD, PhD
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  2. Ulrich Stefenelli
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  3. Oliver Seitz MD
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  4. Marcus Middendorp MD
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  5. Jürgen Diener
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  6. Robert Sader MD, DMD, PhD
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  7. Frank Grünwald MD, PhD
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Corresponding author

Correspondence to Adorján F. Kovács MD, DMD, PhD.

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Kovács, A.F., Stefenelli, U., Seitz, O. et al. Positive Sentinel Lymph Nodes are a Negative Prognostic Factor for Survival in T1-2 Oral/Oropharyngeal Cancer—A Long-Term Study on 103 Patients. Ann Surg Oncol 16, 233–239 (2009). https://doi.org/10.1245/s10434-008-0150-5

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  • DOI: https://doi.org/10.1245/s10434-008-0150-5

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