OBJECTIVE: To evaluate the lack of accuracy in neck staging with the classical technique (i.e., neck dissection and routine histopathology) with the sentinel node (SN) biopsy in oral and oropharyngeal T1-T2N0 cancer. STUDY DESIGN: Cross-sectional study with planned data collection. SETTING: Tertiary center care. SUBJECTS AND METHODS: In 50 consecutive patients, the pathological stage of sentinel node (pSN) was established after analyzing SN biopsies (n = 148) using serial sectioning and immunohistochemistry. Systematic selective neck dissection was performed. The pN stage was established with routine histopathologic analysis of both the non-SN (n = 1075) and the 148 SN biopsies. RESULTS: The sensitivity and negative predictive value of pSN staging were 100 percent. Conversely, if one considers pSN staging procedure as the reference test for micro- and macro-metastasis diagnosis, the sensitivity of the classical pN staging procedure was 50 percent (9/1; 95% CI 26.9-73.1) and its negative predictive value was 78 percent (95% CI 61.9-88.8). Fifteen patients (30%) were upstaged, including nine cases from pN0 to pSN >or= 1 and six cases from pN1 to pSN2. Two of the pN0-pSN1 upstaged patients died with relapsed neck disease. CONCLUSION: The SN biopsy technique appeared to be the best staging method in cN0 patients and provided evidence that routinely undiagnosed lymph node invasion may have clinical significance. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.
OBJECTIVE: To evaluate the lack of accuracy in neck staging with the classical technique (i.e., neck dissection and routine histopathology) with the sentinel node (SN) biopsy in oral and oropharyngeal T1-T2N0 cancer. STUDY DESIGN: Cross-sectional study with planned data collection. SETTING: Tertiary center care. SUBJECTS AND METHODS: In 50 consecutive patients, the pathological stage of sentinel node (pSN) was established after analyzing SN biopsies (n = 148) using serial sectioning and immunohistochemistry. Systematic selective neck dissection was performed. The pN stage was established with routine histopathologic analysis of both the non-SN (n = 1075) and the 148 SN biopsies. RESULTS: The sensitivity and negative predictive value of pSN staging were 100 percent. Conversely, if one considers pSN staging procedure as the reference test for micro- and macro-metastasis diagnosis, the sensitivity of the classical pN staging procedure was 50 percent (9/1; 95% CI 26.9-73.1) and its negative predictive value was 78 percent (95% CI 61.9-88.8). Fifteen patients (30%) were upstaged, including nine cases from pN0 to pSN >or= 1 and six cases from pN1 to pSN2. Two of the pN0-pSN1 upstaged patients died with relapsed neck disease. CONCLUSION: The SN biopsy technique appeared to be the best staging method in cN0 patients and provided evidence that routinely undiagnosed lymph node invasion may have clinical significance. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.
Authors: Dana M Hartl; Alfio Ferlito; Carl E Silver; Robert P Takes; Sandro J Stoeckli; Carlos Suárez; Juan P Rodrigo; Andreas M Sesterhenn; Carl H Snyderman; David J Terris; Eric M Genden; Alessandra Rinaldo Journal: Eur Arch Otorhinolaryngol Date: 2011-05-12 Impact factor: 2.503
Authors: Joost R van der Vorst; Boudewijn E Schaafsma; Floris P R Verbeek; Stijn Keereweer; Jeroen C Jansen; Lilly-Ann van der Velden; Antonius P M Langeveld; Merlijn Hutteman; Clemens W G M Löwik; Cornelis J H van de Velde; John V Frangioni; Alexander L Vahrmeijer Journal: Oral Oncol Date: 2012-08-28 Impact factor: 5.337
Authors: C F Thompson; M A St John; G Lawson; T Grogan; D Elashoff; A H Mendelsohn Journal: Eur Arch Otorhinolaryngol Date: 2012-12-22 Impact factor: 2.503
Authors: Nidal Muhanna; Cheng S Jin; Elizabeth Huynh; Harley Chan; Yi Qiu; Wenlei Jiang; Liyang Cui; Laura Burgess; Margarete K Akens; Juan Chen; Jonathan C Irish; Gang Zheng Journal: Theranostics Date: 2015-10-18 Impact factor: 11.556
Authors: Inne J Den Toom; Elisabeth Bloemena; Stijn van Weert; K Hakki Karagozoglu; Otto S Hoekstra; Remco de Bree Journal: Eur Arch Otorhinolaryngol Date: 2016-08-25 Impact factor: 2.503