title: Predictive factors for failure to identify sentinel nodes in head and neck squamous cell carcinoma.
abstract: BACKGROUND
  The aim of this study was to ascertain which factors determine success of sentinel node biopsy (SNB).
  
  
  METHODS
  We conducted a retrospective review of 121 patients with head and neck squamous cell carcinoma undergoing SNB to stage the neck. All patients underwent the triple-diagnostic procedure of preoperative lymphoscintigraphy, intraoperative blue dye, and a gamma probe. Factors contributing to failure of SNB were identified.
  
  
  RESULTS
  SNB was unsuccessful in 12 of 121 patients (10%). Seven of the 12 patients had cT1/cT2 tumors, and 6 of these were located in the floor of mouth. SN identification was more likely to be successful in patients with cN0 necks, but this did not reach statistical significance (92% vs 84%, p = .268). Factors associated with failure included T classification (p = .01), tumor site (p = .05), and negative preoperative lymphoscintigraphy (p = .0174).
  
  
  CONCLUSIONS
  Successful sentinel lymph node harvest is related to primary tumor site, T classification, and the presence of nodes on preoperative lymphoscintigraphy.
authors.affiliation: Plastic Surgery Unit, Canniesburn Hospital, Glasgow Royal Infirmary, Glasgow, United Kingdom.
authors.forename: Marije T
authors.initials: MT
authors.lastname: Hornstra
authors.forename: Lee W T
authors.initials: LW
authors.lastname: Alkureishi
authors.forename: Gary L
authors.initials: GL
authors.lastname: Ross
authors.forename: Taimur
authors.initials: T
authors.lastname: Shoaib
authors.forename: David S
authors.initials: DS
authors.lastname: Soutar
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome