Arjun Singh1, Satadru Roy2, Vidisha Tuljapurkar2, Deepa Nair2, Pankaj Chaturvedi3. 1. Head and Neck Oncology Department, Tata Memorial Hospital and HBNI, Mumbai, India. 2. Head and Neck Oncology Department, Tata Memorial Centre and HBNI, Mumbai, India. 3. Head and Neck Oncology Department, Tata Memorial Hospital and HBNI, Mumbai, India. chautrvedi.pankaj@gmail.com.
Abstract
PURPOSE OF REVIEW: With contemporary surgery of the cN0 neck in early oral cancer becoming more selective, sentinel node biopsy (SNB) is gaining popularity as a possible alternate option to elective neck dissection (END). This review attempts to critically appraise the current evidence and highlight pertinent arguments for the use of SNB in early oral cancers. RECENT FINDINGS: Based on the recent randomized trials, it is imperative to perform an END at the time of primary resection in cN0 oral cancers. The much criticized false negative rate of SNB can be argued to be equal to the regional failure rate after END for pN0 necks, possibly making a case for SNB due to the reduction in number of neck dissections. There still lies ambiguity on the technique, protocols, and benefit of SNB over END. The role of extended histopathological techniques and the implications of micrometastasis and isolated tumor cells for treatment intensification remain questionable. Currently, SNB is an intermediary between routine imaging and END that needs to evolve before it can become a practice changing alternative to END itself. More efforts are needed in standardizing the protocols for SNB.
PURPOSE OF REVIEW: With contemporary surgery of the cN0 neck in early oral cancer becoming more selective, sentinel node biopsy (SNB) is gaining popularity as a possible alternate option to elective neck dissection (END). This review attempts to critically appraise the current evidence and highlight pertinent arguments for the use of SNB in early oral cancers. RECENT FINDINGS: Based on the recent randomized trials, it is imperative to perform an END at the time of primary resection in cN0 oral cancers. The much criticized false negative rate of SNB can be argued to be equal to the regional failure rate after END for pN0 necks, possibly making a case for SNB due to the reduction in number of neck dissections. There still lies ambiguity on the technique, protocols, and benefit of SNB over END. The role of extended histopathological techniques and the implications of micrometastasis and isolated tumor cells for treatment intensification remain questionable. Currently, SNB is an intermediary between routine imaging and END that needs to evolve before it can become a practice changing alternative to END itself. More efforts are needed in standardizing the protocols for SNB.
Authors: Anthony Po-Wing Yuen; Chiu Ming Ho; Tam Lin Chow; Lap Chiu Tang; Wing Yung Cheung; Raymond Wai-Man Ng; William Ignace Wei; Chi Kwan Kong; Kwok Shing Book; Wai Cheung Yuen; Alfred King-Yin Lam; Nancy Wah-Fun Yuen; Nigel Jeremy Trendell-Smith; Yue Wai Chan; Birgitta Yee-Hang Wong; George Kam-Hop Li; Ambrose Chung-Wai Ho; Wai Kuen Ho; Sau Yan Wong; Tzy-Jyun Yao Journal: Head Neck Date: 2009-06 Impact factor: 3.147
Authors: H Hakan Coskun; Jesus E Medina; K Thomas Robbins; Carl E Silver; Primož Strojan; Afshin Teymoortash; Phillip K Pellitteri; Juan P Rodrigo; Sandro J Stoeckli; Ashok R Shaha; Carlos Suárez; Dana M Hartl; Remco de Bree; Robert P Takes; Marc Hamoir; Karen T Pitman; Alessandra Rinaldo; Alfio Ferlito Journal: Head Neck Date: 2014-06-30 Impact factor: 3.147
Authors: Iain L Hutchison; Fran Ridout; Sharon M Y Cheung; Allan Hackshaw; Neil Shah; Peter Hardee; Christian Surwald; Janavikulam Thiruchelvam; Leo Cheng; Tim K Mellor; Peter A Brennan; Andrew J Baldwin; Richard J Shaw; Wayne Halfpenny; Martin Danford; Simon Whitley; Graham Smith; Malcolm W Bailey; Bob Woodwards; Manu Patel; Joseph McManners; Chi-Hwa Chan; Andrew Burns; Prav Praveen; Andrew C Camilleri; Chris Avery; Graham Putnam; Keith Jones; Keith Webster; William P Smith; Colin Edge; Iain McVicar; Nick Grew; Stuart Hislop; Nicholas Kalavrezos; Ian C Martin Journal: Br J Cancer Date: 2019-10-15 Impact factor: 7.640