Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience

Inne J. den Toom; Koos Boeve; Daphne Lobeek; Elisabeth Bloemena; Maarten L. Donswijk; Bart de Keizer; W. Martin C. Klop; C. René Leemans; Stefan M. Willems; Robert P. Takes; Max J.H. Witjes; Remco de Bree

doi:10.3390/cancers12071783

Cancers (Jul 2020)

Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience

Inne J. den Toom,
Koos Boeve,
Daphne Lobeek,
Elisabeth Bloemena,
Maarten L. Donswijk,
Bart de Keizer,
W. Martin C. Klop,
C. René Leemans,
Stefan M. Willems,
Robert P. Takes,
Max J.H. Witjes,
Remco de Bree

Affiliations

Inne J. den Toom: Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
Koos Boeve: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
Daphne Lobeek: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
Elisabeth Bloemena: Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC/Academic Centre for Dentistry (ACTA), 1081 HV Amsterdam, The Netherlands
Maarten L. Donswijk: Department of Nuclear Medicine, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
Bart de Keizer: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
W. Martin C. Klop: Department of Head and Neck Surgery, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
C. René Leemans: Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC (location VU University Medical Center), 1081 HV Amsterdam, The Netherlands
Stefan M. Willems: Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
Robert P. Takes: Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
Max J.H. Witjes: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
Remco de Bree: Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands

DOI: https://doi.org/10.3390/cancers12071783
Journal volume & issue: Vol. 12, no. 7
p. 1783

Abstract

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Background: Sentinel lymph node biopsy (SLNB) has been introduced as a diagnostic staging modality for detection of occult metastases in patients with early stage oral cancer. Comparisons regarding accuracy to the routinely used elective neck dissection (END) are lacking in literature. Methods: A retrospective, multicenter cohort study included 390 patients staged by END and 488 by SLNB. Results: The overall sensitivity (84% vs. 81%, p = 0.612) and negative predictive value (NPV) (93%, p = 1.000) were comparable between END and SLNB patients. The END cohort contained more pT2 tumours (51%) compared to the SLNB cohort (23%) (p p = 0.006) and NPV (90% vs. 97%, p = 0.057) compared to END. Higher disease-specific survival (DSS) rates were found for pT1 SLNB patients compared to pT1 END patients (96% vs. 90%, p = 0.048). Conclusion: In the absence of randomized clinical trials, this study provides the highest available evidence that, in oral cancer, SLNB is as accurate as END in detecting occult lymph node metastases, except for floor-of-mouth tumours.

Published in Cancers

ISSN: 2072-6694 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.mdpi.com/journal/cancers/

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