Accuracy of sentinel lymph node biopsy in early oral squamous cell carcinoma

Abstract

Objective: This systematic review is performed to investigate and review the application of sentinel lymph node biopsy in early oral squamous cell carcinoma (OSCC), that is, clinical stage T1 and T2 with N0 neck, and no history of previously treated neck. Methods: In order to answer the question “Whether sentinel lymph node biopsy is an accurate diagnostic staging tool for clinical N0 OSCC patients?” An electronic search on PubMed, Medline and the Cochrane Library database was carried out for all relevant articles using specific search keywords. All articles were classified by their level of evidence. Results: A total of 34 studies were included in this review. The mean detection rate for sentinel lymph nodes ranged from 93 to 100%. A mean of 1.5 to 3.8 sentinel lymph nodes were detected per patient. The percentage of upstaging due to detection of occult metastasis present in the sentinel lymph nodes was 9–50% amongst the 34 studies. The mean sensitivity of the procedure is 60–100%, the negative predictive value is 80–100% and the false negative rate is 0–25%. The regional recurrence amongst the negative sentinel lymph node results were reported to be 0–12%. Centre and surgeon experience is crucial in order for the technique to be carried out with a higher sensitivity. Conclusion: Sentinel lymph node biopsy can be an alternative diagnostic strategy to evaluate cT1-T2N0 early oral cancer. It should only be offered as an alternative when the two criteria are met. (1) The equipment for SLNB is available and (2) surgeons performing the SLNB procedure has received adequate training. Copyright © 2017 Published by Elsevier Ltd.