title: Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinoma. Cohort study and meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy of sentinel node biopsy (SNB) in oral squamous cell carcinoma (OSCC).
  
  
  METHODS
  A prospective study of a cohort of 25 consecutive patients with OSCC anatomopathological confirmation through biopsy, without oncological pre-treatment, in clinical stage T1-T4N0, of these 25 patients 14 were T1-T2N0. The absence of regional disease (N0) was determined by means of clinical exploration and cervical tomography (CT). To establish the overall sensitivity of the technique, a meta-analysis was carried out of 10 series published to February 2005 where SNB had been applied to head and neck cancer, adding our 14 T1-T2N0 cases, thus making a total of 260 patients.
  
  
  RESULTS
  Identification by SNB was accurate in 96% of the 25 cases, with a sensitivity of 66.7%. Analyzing only the T1-T2N0 cases (n=14), the accuracy was 100% with a sensitivity of 1 (CI 95%, 0.29-1.00). The overall sensitivity was 93%. The accuracy in identifying the sentinel node varied between 66% and 100%. The SN was identified in 251 of 260 cases, of those, 71 were true positive, 5 false negative and 175 true negative. The overall sensitivity was 93.4% (CI 95%, 85.3-97.8), with a specificity of 100% (CI 95%, 0.98-100). The weighted negative probability quotient was 0.176 (CI 0.103-0.301) and that of positive probability 24.75 (CI 95%, 10.8-56.71). The weighted diagnostic odds ratio was 183.71 (CI 95%, 59.36-568.56). If we accept that the prevalence of hidden regional disease is 30%, a negative sentinel node has 5% possibility of having hidden disease.
  
  
  CONCLUSIONS
  Our data provide a certain degree of evidence that, due to its high sensitivity, the SNB procedure can be applied to the initial stages of OSCC.
authors.affiliation: Facultativo Especialista de Area, Hospital de Cruces, Servicio Vasco de Salud, Osakidetza. Bilbao, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Alvarez Amézaga
authors.forename: Luis
authors.initials: L
authors.lastname: Barbier Herrero
authors.forename: José I
authors.initials: JI
authors.lastname: Pijoan del Barrio
authors.forename: Jesús C
authors.initials: JC
authors.lastname: Martín Rodríguez
authors.forename: Laura
authors.initials: L
authors.lastname: Romo Simón
authors.forename: José
authors.initials: J
authors.lastname: Genolla Subirats
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Rios Altolaguirre
authors.forename: Antonio
authors.initials: A
authors.lastname: de los Ríos
authors.forename: Icíar
authors.initials: I
authors.lastname: Arteagoitia Calvo
authors.forename: Salvador
authors.initials: S
authors.lastname: Landa Llona
authors.forename: Jose A
authors.initials: JA
authors.lastname: Arruti González
authors.forename: José
authors.initials: J
authors.lastname: López Cedrún
authors.forename: Joseba
authors.initials: J
authors.lastname: Santamaría Zuazua
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy