Annals of Surgical Oncology

, Volume 11, Issue 7, pp 690–696 | Cite as

Sentinel Node Biopsy in Head and Neck Cancer: Preliminary Results of a Multicenter Trial

  • Gary L. Ross
  • David S. Soutar
  • D. Gordon MacDonald
  • Taimur Shoaib
  • Ivan Camilleri
  • Andrew G. Roberton
  • Jens A. Sorensen
  • Jorn Thomsen
  • Peter Grupe
  • Julio Alvarez
  • L. Barbier
  • J. Santamaria
  • Tito Poli
  • Olindo Massarelli
  • Enrico Sesenna
  • Adorján F. Kovács
  • Frank Grünwald
  • Luigi Barzan
  • Sandro Sulfaro
  • Franco Alberti
Original Articles


Background: The aim was to determine the reliability and reproducibility of sentinel node biopsy (SNB) as a staging tool in head and neck squamous cell carcinoma (HNSCC) for T1/2 clinically N0 patients by means of a standardized technique.

Methods: Between June 1998 and June 2002, 227 SNB procedures have been performed in HNSCC cases at six centers. One hundred thirty-four T1/2 tumors of the oral cavity/oropharynx in clinically N0 patients were investigated with preoperative lymphoscintigraphy (LSG), intraoperative use of blue dye/gamma probe, and pathological evaluation with step serial sectioning and immunohistochemistry, with a follow-up of at least 12 months. In 79 cases SNB alone was used to stage the neck carcinoma, and in 55 cases SNB was used in combination with an elective neck dissection (END).

Results: In 125/134 cases (93%) a sentinel node was identified. Of 59 positive nodes, 57 were identified with the intraoperative gamma probe and 44 with blue dye. Upstaging of disease occurred in 42/125 cases (34%): with hematoxylin-eosin in 32/125 (26%) and with additional pathological staging in 10/93 (11%). The sensitivity of the technique with a mean follow-up of 24 months was 42/45 (93%). The identification of SNB for floor of mouth (FOM) tumors was 37/43 (86%), compared with 88/91 (97%) for other tumors. The sensitivity for FOM tumors was 12/15 (80%), compared with 30/30 (100%) for other tumor groups.

Conclusion: SNB can be successfully applied to early T1/2 tumors of the oral cavity/oropharynx in a standardized fashion by centers worldwide. For the majority of these tumors the SNB technique can be used alone as a staging tool.

Key Words:

Cervical metastases Elective neck dissection Head and neck Neoplasms Sentinel node biopsy 


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Copyright information

© The Society of Surgical Oncology, Inc. 2004

Authors and Affiliations

  • Gary L. Ross
    • 1
    • 13
  • David S. Soutar
    • 1
  • D. Gordon MacDonald
    • 2
  • Taimur Shoaib
    • 1
  • Ivan Camilleri
    • 1
  • Andrew G. Roberton
    • 3
  • Jens A. Sorensen
    • 4
  • Jorn Thomsen
    • 4
  • Peter Grupe
    • 5
  • Julio Alvarez
    • 6
  • L. Barbier
    • 6
  • J. Santamaria
    • 6
  • Tito Poli
    • 7
  • Olindo Massarelli
    • 7
  • Enrico Sesenna
    • 7
  • Adorján F. Kovács
    • 8
  • Frank Grünwald
    • 9
  • Luigi Barzan
    • 10
  • Sandro Sulfaro
    • 11
  • Franco Alberti
    • 12
  1. 1.Plastic Surgery UnitCanniesburn HospitalBearsdenUK
  2. 2.Department of Oral PathologyGlasgow Royal InfirmaryGlasgowUK
  3. 3.Beatson Oncology CentreGlasgowUK
  4. 4.Departments of Plastic and Reconstructive SurgeryOdense University HospitalOdenseDenmark
  5. 5.Departments of Nuclear MedicineOdense University HospitalOdenseDenmark
  6. 6.Servicio de C. MaxilofacialHospital de CrucesCrucesSpain
  7. 7.Sezione di Chirurgia Maxillo-Faciale, Dipartmento di Scienze Otorino-Odonto-Oftalmologiche e Cervico FaccialiUniversity Hospital of ParmaParmaItaly
  8. 8.Clinic for Maxillofacial Plastic SurgeryJohann Wolfgang Goethe University Medical School, Frankfurt am MainGermany
  9. 9.Department of Nuclear MedicineJohann Wolfgang Goethe University Medical School, Frankfurt am MainGermany
  10. 10.Operative Units of OtolaryngologyAzienda Ospedaliera “S. Maria degli Angeli,”PordenoneItaly
  11. 11.Department of PathologyAzienda Ospedaliera “S. Maria degli Angeli,”PordenoneItaly
  12. 12.Department of Nuclear MedicineAzienda Ospedaliera “S. Maria degli Angeli,”PordenoneItaly
  13. 13.DidsburyUK

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