Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinoma. Cohort study and meta-analysis.
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.
Alvarez Amézaga
Julio
J
Facultativo Especialista de Area, Hospital de Cruces, Servicio Vasco de Salud, Osakidetza. Bilbao, Spain.
Barbier Herrero
Luis
L
Pijoan del Barrio
José I
JI
Martín Rodríguez
Jesús C
JC
Romo Simón
Laura
L
Genolla Subirats
José
J
Rios Altolaguirre
Gonzalo
G
de los Ríos
Antonio
A
Arteagoitia Calvo
Icíar
I
Landa Llona
Salvador
S
Arruti González
Jose A
JA
López Cedrún
José
J
Santamaría Zuazua
Joseba
J
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