Clare Schilling1, Sandro J Stoeckli2, Stephan K Haerle3, Martina A Broglie2, Gerhard F Huber4, Jens Ahm Sorensen5, Vivi Bakholdt5, Annelise Krogdahl6, Christian von Buchwald7, Anders Bilde7, Lars R Sebbesen7, Edward Odell8, Benjamin Gurney1, Michael O'Doherty9, Remco de Bree10, Elisabeth Bloemena11, Geke B Flach10, Pedro M Villarreal12, Manuel Florentino Fresno Forcelledo13, Luis Manuel Junquera Gutiérrez12, Julio Alvarez Amézaga14, Luis Barbier14, Joseba Santamaría-Zuazua14, Augusto Moreira15, Manuel Jacome15, Maurizio Giovanni Vigili16, Siavash Rahimi17, Girolamo Tartaglione18, Georges Lawson19, Marie-Cecile Nollevaux19, Cesare Grandi20, Davide Donner21, Emma Bragantini22, Didier Dequanter23, Philippe Lothaire23, Tito Poli24, Enrico M Silini25, Erinco Sesenna24, Giles Dolivet26, Romina Mastronicola26, Agnes Leroux27, Isabel Sassoon28, Philip Sloan29, Mark McGurk30. 1. Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK. 2. Department of Otorhinolaryngology, Head and Neck Surgery Kantonsspital St Gallen, Switzerland. 3. Department of Head and Neck Surgery, University of Basel, Switzerland. 4. Department of Otolaryngology University Hospital Zurich, Switzerland. 5. Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark. 6. Department of Pathology, Odense University Hospital, Denmark. 7. Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark. 8. Head and Neck/Oral Pathology, King's College London, Guys and St Thomas NHS Trust, London, UK. 9. Department of Nuclear Medicine, Guys and St Thomas NHS Trust, London, UK. 10. Department of Otolaryngology Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands. 11. Department of Pathology, VU University Medical Centre and Academic Centre of Dentistry Amsterdam, The Netherlands. 12. Department of Maxillofacial Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain. 13. Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain. 14. Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain. 15. Department of Head and Neck Surgery, Instituto Portugues de Oncologia do Porto, Portugal. 16. Department of Otorhinolaryngology, San Carlo Hospital Rome, Italy. 17. Department of Histopathology, San Carlo Hospital Rome, Italy. 18. Department of Nuclear Medicine, Cristo Re Hospital, Rome, Italy. 19. Department of Head and Neck Surgery, CHU Dinant Godinne, Université Catholique de Louvain, Belgium. 20. Department of Otolaryngology, Ospedale S. Chiara, Trento, Italy. 21. Department of Nuclear Medicine, Ospedale S. Chiara, Trento, Italy. 22. Department of Surgical Pathology, Ospedale S. Chiara, Trento, Italy. 23. Department of Maxillofacial Surgery CHU de Charleroi Belgium, Belgium. 24. Department of Maxillofacial Surgery, Azienda Ospedaliera, Universitaria of Parma, Italy. 25. Department of Pathology Azienda Ospedaliera Universitaria of Parma, Italy. 26. Department of Head and Neck Surgery Centre Alexis Vautrin, Vandoeuvre Les Nancy, France. 27. Department of Pathology Centre Alexis Vautrin, Vandoeuvre Les Nancy, France. 28. Department of Informatics, Kings' College London, UK. 29. Department of Cellular Pathology, Newcastle University Hospital, UK. 30. Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK. Electronic address: mark.mcgurk@kcl.ac.uk.
Abstract
PURPOSE: Optimum management of the N0 neck is unresolved in oral cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis. The object of this study was to establish whether the technique was both reliable in staging the N0 neck and a safe oncological procedure in patients with early-stage oral squamous cell carcinoma. METHODS: An European Organisation for Research and Treatment of Cancer-approved prospective, observational study commenced in 2005. Fourteen European centres recruited 415 patients with radiologically staged T1-T2N0 squamous cell carcinoma. SNB was undertaken with an average of 3.2 nodes removed per patient. Patients were excluded if the sentinel node (SN) could not be identified. A positive SN led to a neck dissection within 3 weeks. Analysis was performed at 3-year follow-up. RESULTS: An SN was found in 99.5% of cases. Positive SNs were found in 23% (94 in 415). A false-negative result occurred in 14% (15 in 109) of patients, of whom eight were subsequently rescued by salvage therapy. Recurrence after a positive SNB and subsequent neck dissection occurred in 22 patients, of which 16 (73%) were in the neck and just six patients were rescued. Only minor complications (3%) were reported following SNB. Disease-specific survival was 94%. The sensitivity of SNB was 86% and the negative predictive value 95%. CONCLUSION: These data show that SNB is a reliable and safe oncological technique for staging the clinically N0 neck in patients with T1 and T2 oral cancer. EORTC Protocol 24021: Sentinel Node Biopsy in the Management of Oral and Oropharyngeal Squamous Cell Carcinoma.
PURPOSE: Optimum management of the N0 neck is unresolved in oral cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis. The object of this study was to establish whether the technique was both reliable in staging the N0 neck and a safe oncological procedure in patients with early-stage oral squamous cell carcinoma. METHODS: An European Organisation for Research and Treatment of Cancer-approved prospective, observational study commenced in 2005. Fourteen European centres recruited 415 patients with radiologically staged T1-T2N0 squamous cell carcinoma. SNB was undertaken with an average of 3.2 nodes removed per patient. Patients were excluded if the sentinel node (SN) could not be identified. A positive SN led to a neck dissection within 3 weeks. Analysis was performed at 3-year follow-up. RESULTS: An SN was found in 99.5% of cases. Positive SNs were found in 23% (94 in 415). A false-negative result occurred in 14% (15 in 109) of patients, of whom eight were subsequently rescued by salvage therapy. Recurrence after a positive SNB and subsequent neck dissection occurred in 22 patients, of which 16 (73%) were in the neck and just six patients were rescued. Only minor complications (3%) were reported following SNB. Disease-specific survival was 94%. The sensitivity of SNB was 86% and the negative predictive value 95%. CONCLUSION: These data show that SNB is a reliable and safe oncological technique for staging the clinically N0 neck in patients with T1 and T2 oral cancer. EORTC Protocol 24021: Sentinel Node Biopsy in the Management of Oral and Oropharyngeal Squamous Cell Carcinoma.
Authors: Pieter D de Veij Mestdagh; Marcel C J Jonker; Wouter V Vogel; Willem H Schreuder; Maarten L Donswijk; W Martin C Klop; Abrahim Al-Mamgani Journal: Eur Arch Otorhinolaryngol Date: 2018-06-28 Impact factor: 2.503
Authors: Rutger Mahieu; Gerard C Krijger; F F Tessa Ververs; Remmert de Roos; Remco de Bree; Bart de Keizer Journal: Eur J Nucl Med Mol Imaging Date: 2021-04 Impact factor: 9.236
Authors: Somiah Siddiq; David Cartlidge; Sarah Stephen; Hans P Sathasivam; Hannah Fox; James O'Hara; David Meikle; Muhammad Shahid Iqbal; Charles G Kelly; Max Robinson; Vinidh Paleri Journal: Eur Arch Otorhinolaryngol Date: 2018-05-12 Impact factor: 2.503
Authors: Shlomo A Koyfman; Nofisat Ismaila; Doug Crook; Anil D'Cruz; Cristina P Rodriguez; David J Sher; Damian Silbermins; Erich M Sturgis; Terance T Tsue; Jared Weiss; Sue S Yom; F Christopher Holsinger Journal: J Clin Oncol Date: 2019-02-27 Impact factor: 44.544