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Apr 29, 2013Article Details
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Does sentinel lymph node biopsy have a role in nodepositive head and neck squamous carcinoma?
Abstract
Objectives/hypothesis. The objective of the study was to determine whether sentinel lymph node biopsy (SLNB) can be used to reduce clinical
overstaging of cervical nodes in head and neck squamous cell carcinoma (SCC) in a developing world setting.
Study design. Sentinel and echelon lymph nodes were identified by means of a combination of lymphoscintigraphy, gamma probe and blue
dye staining. They were analysed histologically and their pathological status was compared with the rest of the neck dissection specimen to
determine diagnostic accuracy in patients with T1-4 N0-3 SCC of the oral cavity or oropharynx undergoing primary surgical resection and
neck dissection.
Results. Thirty-three patients were included in the study, 13 in the node-negative (N0) and 20 in the node-positive (N+) group. In the
clinically N0 group the sensitivity of SLNB was 100% and the negative predictive value (NPV) 100%. In the clinically N+ group the sensitivity
was 71% and the NPV 60% for staging the nodal status of the neck.
Conclusion. The accuracy of SLNB in the clinically N+ neck is too low for SLNB to be a means of avoiding comprehensive neck dissection.
Level of evidence: 2B.
overstaging of cervical nodes in head and neck squamous cell carcinoma (SCC) in a developing world setting.
Study design. Sentinel and echelon lymph nodes were identified by means of a combination of lymphoscintigraphy, gamma probe and blue
dye staining. They were analysed histologically and their pathological status was compared with the rest of the neck dissection specimen to
determine diagnostic accuracy in patients with T1-4 N0-3 SCC of the oral cavity or oropharynx undergoing primary surgical resection and
neck dissection.
Results. Thirty-three patients were included in the study, 13 in the node-negative (N0) and 20 in the node-positive (N+) group. In the
clinically N0 group the sensitivity of SLNB was 100% and the negative predictive value (NPV) 100%. In the clinically N+ group the sensitivity
was 71% and the NPV 60% for staging the nodal status of the neck.
Conclusion. The accuracy of SLNB in the clinically N+ neck is too low for SLNB to be a means of avoiding comprehensive neck dissection.
Level of evidence: 2B.
