Sentinel lymph node biopsy in early-stage oral squamous cell carcinoma: A retrospective single-center analysis

J Craniomaxillofac Surg. 2024 Dec;52(12):1428-1433. doi: 10.1016/j.jcms.2024.08.012. Epub 2024 Aug 22.

Abstract

Sentinel lymph node biopsy (SLNB) is increasingly incorporated in European national guidelines for the management of the clinically node-negative neck (cN0) in early-stage oral squamous cell carcinoma (OSCC). In Germany, SLNB in OSCCs is not yet routinely performed. This study aimed to evaluate the clinical outcome of SLNB in a German cohort. Patients with primary early-stage OSCC who underwent tumor resection and SLNB were retrospectively analyzed. Clinical-pathological characteristics were documented. Primary endpoints were sensitivity and the negative predictive value (NPV). A total of 46 patients with a mean age of 62.3 (±14.5) years met the inclusion criteria. Most tumors were located in the tongue (63.0%). Bilateral drainage from a lateral tumor was observed in three cases (6.5%), and sentinel lymph node metastasis was detected in three patients (6.5%). Mean follow-up for all patients was 13.8 months (±9.6). One patient developed regional recurrence following a negative SLNB during the observation period, leading to an NPV of 0.98 and a sensitivity of 75.0%. The 2-year neck-specific relapse-free survival was 92.8%. SLNB in early-stage OSCC is a reliable diagnostic tool of the cN0 neck, ensuring a high NPV and RFS. SLNB can be advantageous in comparison to elective neck dissection due to the detection of contralateral lymph drainage.

Keywords: Early-stage; Neck dissection; Oral squamous cell carcinoma; Sentinel lymph node biopsy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Female
  • Humans
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Mouth Neoplasms* / pathology
  • Mouth Neoplasms* / surgery
  • Neoplasm Staging*
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy*