title: The relative cost of sentinel lymph node biopsy in early oral cancer.
abstract: BACKGROUND
  The European Sentinel Node (SENT) trial addressed the question of the clinically lymph node negative (cN0) neck in early oral squamous cell carcinoma (OSCC). Apart from reducing neck dissection numbers, sentinel lymph node biopsy (SLNB) may reduce treatment cost. Using a treatment model derived from SENT trial information, estimates were produced of relative treatment costs between patients managed through a traditional surgical or SLNB pathway.
  
  
  METHODS
  The model created two management approaches, the traditional surgical pathway and SLNB pathway. Using SENT trial data regarding the proportion of patients with positive, negative and false negative SLNB's a relative cost ratio (RCR) for 100 hypothetical patients passing down each pathway was generated.
  
  
  RESULTS
  From a cohort of 481 patients, 25% had a positive SLNB, 75% a negative result and 2.5% a false negative result. Treatment of 100 hypothetical patients using the SLNB pathway is 0.35-0.60 the cost of treating the same cohort using traditional surgery techniques. Even if 100% of SLNB's are positive the SLNB approach is 0.91 of the cost of the traditional surgical approach.
  
  
  CONCLUSIONS
  The SLNB approach appears to be cheaper relative to the traditional surgical approach, especially when extrapolated to 100 hypothetical patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Guy's Hospital, London, UK. Electronic address: rory.oconnor@doctors.net.uk.
authors.forename: Rory
authors.initials: R
authors.lastname: O'Connor
authors.forename: Tom
authors.initials: T
authors.lastname: Pezier
authors.forename: Clare
authors.initials: C
authors.lastname: Schilling
authors.forename: Mark
authors.initials: M
authors.lastname: McGurk
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000191:economics*; D059186:Chemoradiotherapy, Adjuvant / Q000191:economics; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D055088:Early Detection of Cancer / Q000191:economics*; D017558:Elective Surgical Procedures / Q000191:economics; D005188:False Negative Reactions; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000191:economics*; D037981:Neck Dissection / Q000191:economics; D009367:Neoplasm Staging; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant / Q000191:economics; D021701:Sentinel Lymph Node Biopsy / Q000191:economics*
keywords: Cost analysis; Lymphatic metastasis; Oral squamous cell carcinoma; Sentinel lymph node biopsy