title: Sentinel node biopsy for early-stage oral cavity cancer: the VU University Medical Center experience.
abstract: BACKGROUND
  Sentinel node biopsy (SNB) in head and neck cancer is recently introduced as the staging technique of oral squamous cell carcinoma. We report the results of SNB in patients diagnosed with a T1-T2 oral squamous cell carcinoma and clinically negative (N0) neck in a single center.
  
  
  METHODS
  A retrospective analysis of 90 previously untreated patients who underwent SNB between 2007 and 2012 was performed. The SNB procedure consisted of preoperatively performed lymphoscintigraphy, intraoperative detection using blue dye, and gamma probe guidance and histopathologic examination including step-serial sectioning (SSS) and immunohistochemical (IHC) staining. A positive SNB was followed by neck dissection, whereas regular follow-up with ultrasound-guided fine-needle aspiration cytology (FNAC) was done in case of a negative SNB.
  
  
  RESULTS
  The lymphoscintigraphic identification rate was 98% (88 of 90 patients) and the surgical detection rate was 99% (87 of 88 patients). The upstaging rate was 30%. Sensitivity of SNB was 93% and the negative predictive value was 97%. The median follow-up was 18 months (range, 2-62 months). Overall survival (OS) and disease-free survival (DFS) for SNB negative were 100% and 84% and for SNB positive patients 73% and 88%, respectively.
  
  
  CONCLUSIONS
  SNB is a reliable diagnostic staging technique for the clinically negative neck in patients with early-stage (T1-T2, cN0) oral squamous cell carcinoma.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Inne J
authors.initials: IJ
authors.lastname: Den Toom
authors.forename: Derrek A
authors.initials: DA
authors.lastname: Heuveling
authors.forename: Géke B
authors.initials: GB
authors.lastname: Flach
authors.forename: Stijn
authors.initials: S
authors.lastname: van Weert
authors.forename: K Hakki
authors.initials: KH
authors.lastname: Karagozoglu
authors.forename: Annelies
authors.initials: A
authors.lastname: van Schie
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bloemena
authors.forename: C René
authors.initials: CR
authors.lastname: Leemans
authors.forename: Remco
authors.initials: R
authors.lastname: de Bree
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy; D059248:Chemoradiotherapy; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009426:Netherlands; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis
keywords: lymph node metastasis; oral cancer; sentinel node biopsy; squamous cell carcinoma