Reliability evaluation of sentinel node biopsy in T1 / T2 N0 squamous cell carcinoma of the oral cavity by comparing patients operated on for sentinel node and those operated on with neck dissection.

Abstract

Introduction: Head and neck cancer corresponds to 3% of cancers in general; it is the sixth most common worldwide and the most frequent anatomical subsite of the oral cavity (30%). The most frequent histological type is squamous cell carcinoma in more than 90%. Tumor size and depth of invasion have been associated with prognosis; those classified T3-T4 have up to 70% lymph node metastases. The sentinel node concept has been accepted in the treatment of early stage oral cancer. Methods: A systematic review of randomized clinical trials of patients with squamous cell carcinoma of the oral cavity with negative necks who underwent sentinel node technique or neck dissection was performed. The search was from January 2000 to June 2021. Analysis and presentation of results: The articles evaluated were 6, clinical trials that performed preoperative peritumoral injection of technetium radiocolloid and lymphoscintigraphy, followed by sentinel node with intraoperative gamma probe. In the studies presented, the disease-free survival rate was between 89% -91% and the overall local recurrence rate was 18% -24% in patients with positive sentinel node. Sentinel node sensitivity is 93% and negative predictive value 97%. Conclusions: The sentinel node is a useful and reliable tool for use in patients with T1 / T2N0 squamous cell carcinoma of the oral cavity. Most patients with positive sentinel node biopsies have additional positive nodes on neck dissection. Individuals with negative sentinel node biopsy results appear to have better overall and disease-specific survival.