Sentinel Node Biopsy in Oral Cancer
In patients with cT1-T2 oral/oropharyngeal squamous cell cancer, involvement of the cervical lymph nodes is associated with a 50% decrease in 5-year survival and represents the most important prognostic factor in this patient group. Precise staging of the cervical nodes is therefore of utmost importance, to ensure an accurate prognosis and provision of the most appropriate treatment.
The gold standard for staging the cervical nodes is elective neck dissection, providing both diagnostic and therapeutic measures. However, only one-fourth of cT1-T2 patients are found to harbor occult nodal disease, and the remainder of patients may be unnecessarily exposed to the considerable morbidity associated with neck dissection.
The sentinel node biopsy procedure provides a means of obtaining tissue for pathological staging of the cervical lymph node basin, while potentially avoiding the morbidity of an elective neck dissection. This chapter describes the technique, its accuracy and current applications, and its potential role in the management of patients with early oral/oropharyngeal squamous cell cancer.
KeywordsSentinel Node Sentinel Node Biopsy Neck Dissection Lymphatic Mapping Positive Sentinel Lymph Node
- Alkureishi LWT, Ross GL, Shoaib T, Sorensen J, Alvarez J, Poli T, Kovacs A, Alberti F, Soutar DS (2008) Sentinel node biopsy in oral/oropharyngeal squamous cell cancer: five year follow-up. Presented at the Annual Meeting of the American Head and Neck Society (AHNS), San Francisco, July 2008Google Scholar
- Gallegos-Hernández JF, Hernández-Hernández DM, Flores-Díaz R, Sierra-Santiesteban I, Pichardo-Romero P, Arias-Ceballos H, Minauro-Muñoz G, Alvarado-Cabrero I (2005) The number of sentinel nodes identified as prognostic factor in oral epidermoid cancer. Oral Oncol 41(9):947–952CrossRefPubMedGoogle Scholar
- Haerle SK, Hany TF, Strobel K, Sidler D, Stoeckli SJ (in press) Is there an additional value of SPECT/CT over lymphoscintigraphy for sentinel node mapping in oral/oropharyngeal squamous cell carcinoma? J Nucl MedGoogle Scholar
- Kosuda S, Kusano S, Kohno N, Ohno Y, Tanabe T, Kitahara S, Tamai S (2003) Feasibility and cost-effectiveness of sentinel lymph node radiolocalization in stage N0 head and neck cancer. Arch Otolaryngol Head Neck Surg 129(10):1105–1109 Erratum in: Arch Otolaryngol Head Neck Surg 2003;129(11):1229CrossRefPubMedGoogle Scholar
- Morton DL, Thompson JF, Cochran AJ, Mozzillo N, Elashoff R, Essner R, Nieweg OE, Roses DF, Hoekstra HJ, Karakousis CP, Reintgen DS, Coventry BJ, Glass EC, Wang HJ, MSLT Group (2006) Sentinel-node biopsy or nodal observation in melanoma. N Engl J Med 355(13):1307–1317 Erratum in: N Engl J Med 2006;355(18):1944CrossRefPubMedGoogle Scholar
- Nieuwenhuis EJ, Castelijns JA, Pijpers R, van den Brekel MW, Brakenhoff RH, van der Waal I, Snow GB, Leemans CR (2002) Wait-and-see policy for the N0 neck in early-stage oral and oropharyngeal squamous cell carcinoma using ultrasonography-guided cytology: is there a role for identification of the sentinel node? Head Neck 24(3):282–289CrossRefPubMedGoogle Scholar
- Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, Mariotto A, Miller BA, Feuer EJ, Altekruse SF, Lewis DR, Clegg L, Eisner MP, Reichman M, Edwards BK (eds) (2008) SEER Cancer Statistics Review, 1975–2005. National Cancer Institute, Bethesda, MDGoogle Scholar
- Ross GL, Soutar DS, Gordon MacDonald D, Shoaib T, Camilleri I, Roberton AG, Sorensen JA, Thomsen J, Grupe P, Alvarez J, Barbier L, Santamaria J, Poli T, Massarelli O, Sesenna E, Kovács AF, Grünwald F, Barzan L, Sulfaro S, Alberti F (2004b) Sentinel node biopsy in head and neck cancer: preliminary results of a multicenter trial. Ann Surg Oncol 11(7):690–696CrossRefPubMedGoogle Scholar
- Ross GL, on behalf of the Sentinel European Node Trial (SENT) organising committee. Sentinel Node Biopsy for Squamous Cell Carcinoma of the Oral Cavity: Preliminary results of the SENT Trial. Presented at the Annual Meeting of the American Head and Neck Society (AHNS), San Francisco, July 2008Google Scholar
- Sobin LH, Wittekind Ch (eds) (2002) TNM classification of malignant tumors, 6th edn. Wiley, New YorkGoogle Scholar
- Stoeckli SJ, Schuknecht B, Strobel K (in press) Initial Staging of the Neck in HNSCC: Is PET/CT the best? Head NeckGoogle Scholar