Reliability the sentinel lymph node in squamous cell carcinoma the oral cavity T1 / T2 N0.

Abstract

Head and neck cancer corresponds to 3% of cancers in general; it is the sixth most common worldwide, most frequently affecting the oral cavity (30%). The most frequent histological type is squamous cell carcinoma (90%). Tumor size and depth of invasion are 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. Objective: To evaluate the reliability of the sentinel lymph node in squamous cell carcinoma of the oral cavity T1 / T2 N0. 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 cervical dissection (January 2000 to June 2021 period) was carried out. Results: The articles evaluated were 6, clinical trials that performed preoperative peritumoral injection of technetium radiocolloid and lymphoscintigraphy, followed by sentinel lymph node with intraoperative gamma probe. The disease-free survival rate was between 89%-91% and the overall rate of local recurrence was 18%-24% in patients with positive sentinel node. The sensitivity of the sentinel lymph node is 93% and the negative predictive value is 97%. Conclusions: The sentinel node is a useful and reliable tool for use in patients with squamous cell carcinoma of the oral cavity T1/T2N0. 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.