Sentinel node biopsy for early oral carcinoma.
OBJECTIVE
Sentinel node biopsy (SNB) in oral squamous cell carcinomas (OSCCs) has been under investigation since more than a decade. Numerous published studies and recent important scientific data support its role as an alternative standard of care apart from elective neck dissection.


RESULTS
During the past 2 years, a large-scale multicentric validation trial and long-term follow-ups of major observational trials have demonstrated the accuracy and oncological safety and efficacy of SNB to stage a cN0 early stage OSCC. Histologic and molecular parameters of the primary tumors possibly predicting occult disease in the neck have been evaluated, but SNB with the use of step-serial sectioning and immunohistochemistry remains the most accurate staging method. SNB has been shown to be clearly superior to elective neck dissection with regard to complications and morbidity. The modern technique of quantitative real-time reverse transcriptase-polymerase chain reaction has been successfully used for the rapid intraoperative assessment of the sentinel nodes, allowing a one-stage procedure in all patients. The procedure of SNB is currently expanding to other areas like the supraglottic larynx and the previously treated neck.


CONCLUSIONS
SNB in OSCC is a minimally invasive and highly reliable staging method of the cN0 neck and has become the standard of care in many centers throughout the world. Recent developments have led to a wider clinical application and improved acceptance.
Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital St Gallen, St Gallen, Switzerland. sandro.stoeckli@kssg.ch
Sandro J
SJ
Stoeckli
Martina A
MA
Broglie
D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005629:Frozen Sections; D006258:Head and Neck Neoplasms / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D009333:Neck; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy