Sentinel Node Biopsy in Oral Squamous Cell Carcinoma: Our experience

Methods: we report a 5-year follow-up (mean 5,3±2,96) of 89 patients diagnosed and treated of oral cavity SCC in early stages (T_1-2N₀). Lymphatic mapping consisted of preoperative lymphoscintigraphy and intra operative use of a hand-held gamma-probe. There were 56 patients who underwent SNB as the sole staging tool, while 33 patients underwent SNB-assisted of other techniques of the neck dissection.

Results: the sentinel node detection rate was 100% and the negative predictive value (NPV) was 100%. SNB was positive for SCC in 24 cases (26.9%) which upstaged the patients. Recurrence was present in 27 cases (30.3%) without a significant difference between both study groups. There were 19 recurrences in the group of SNB as the sole staging tool and 8 recurrences in the group of SNB-assisted of other techniques of the neck dissection. Average survival rate was 9 years (range 2,6-16,1), and the 5-year survival rate was 68.1%. No differences were detected in survival between patients with positive or negative SNB (p=0,113). Neither statistical differences in survival were detected in floor of the mouth cases compared to other oral locations. Survival was higher in T1, 8.253 years±0.510, than in T2, 7.421±0.441 (p=0.034).

Conclusions: the sentinel node detection has a high detection rate, with a NPV against standard neck dissection of 100%. No significant differences were found to recurrences. Nevertheless, no changes in survival of early staged oral SCC patients are found after this technique against other forms of radical neck dissection.  T1 SCC have longer survival than T2.