title: Does sentinel lymph node biopsy have a role in node-positive head and neck squamous carcinoma?
abstract: OBJECTIVE
  The objective of the study was to determine whether sentinel lymph node biopsy (SLNB) can be used to reduce clinical overstaging of cervical nodes in head and neck squamous cell carcinoma (SCC) in a developing world setting.
  
  
  METHODS
  Sentinel and echelon lymph nodes were identified by means of a combination of lymphoscintigraphy, gamma probe and blue dye identification. They were analysed histologically and their pathological status was compared with the rest of the neck dissection specimen to determine diagnostic accuracy in patients with T1-4 N0-3 SCC of the oral cavity or oropharynx undergoing primary surgical resection and neck dissection.
  
  
  RESULTS
  Thirty-three patients were included in the study, 13 in the node-negative (N0) and 20 in the node-positive (N+) group. In the clinically N0 group the sensitivity of SLNB was 100% and the negative predictive value (NPV) 100%. In the clinically N+ group the sensitivity was 71% and the NPV 60% for staging the nodal status of the neck. CONCLUSIONS; The accuracy of SLNB in the clinically N+ neck is too low for SLNB to be a means of avoiding comprehensive neck dissection.
  
  
  METHODS
  2B.
authors.affiliation: Division of Otolaryngology, University of Cape Town, South Africa. o.edkins@uct.ac.za
authors.forename: O
authors.initials: O
authors.lastname: Edkins
authors.forename: C
authors.initials: C
authors.lastname: Hofmeyr
authors.forename: J J
authors.initials: JJ
authors.lastname: Fagan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D009333:Neck; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy