title: Comparative study of sentinel lymph node biopsy in clinically N0 oral tongue squamous cell carcinoma: Long-term oncologic outcomes between validation and application phases.
abstract: OBJECTIVE
  This study tested the long-term outcomes of sentinel lymph node biopsy (SLNB) for oral tongue squamous cell carcinoma (SCC) during the transition from validation to application phase.
  
  
  METHODS
  Sensitivity, negative predictive value (NPV), neck control rate, disease-specific survival (DSS), disease-free survival (DFS), and overall survival (OS) were compared in cN0 oral tongue SCC patients from different phases.
  
  
  RESULTS
  A total of 133 SLNs from 61 patients (21 in the validation phase, 40 in the application phase) were harvested. Fourteen SLNs of 12 patients (6 in each phase) were positive for metastasis (occult metastasis rate, 19.6%). Regional recurrences developed from 5 negative SLNs (one in the validation phase, 4 in the application phase), of whom 3 patients were successfully salvaged. Sensitivity and NPV of the validation phase were both 100%, with 60.0% and 88.2% in the application phase. False omission rates were 6.6% (1/15) in the validation group, and 11.7% (4/34) in the application group, respectively. The neck control rate was 95.2% in the validation phase and 97.5% in the application phase (p=0.52). No differences were evident in DSS, DFS, and OS between the two phases (DSS: 92.5% vs 95.2%, p=0.69; DFS: 85.0% vs 90.4%, p=0.40; OS: 90% vs 85.5%, p=0.62). Subgroup analyses between negative- and positive-SLNs within each phase revealed no significant differences in all endpoints.
  
  
  CONCLUSIONS
  Given higher false negative cases in the application phase, stringent strategy of follow-up and salvage treatment is mandatory to maintain acceptable outcomes.
authors.affiliation: Department of Otorhinolaryngology -Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors.forename: Man Ki
authors.initials: MK
authors.lastname: Chung
authors.affiliation: Department of Otorhinolaryngology -Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors.forename: Gil Joon
authors.initials: GJ
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology -Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors.forename: Nayeon
authors.initials: N
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Pusan National University Yansan Hospital, Puasn National University, Busan, South Korea.
authors.forename: Jae-Keun
authors.initials: JK
authors.lastname: Cho
authors.affiliation: Department of Otorhinolaryngology -Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
authors.forename: Han-Sin
authors.initials: HS
authors.lastname: Jeong
authors.affiliation: Department of Otorhinolaryngology -Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea. Electronic address: chunghwan.baek@gmail.com.
authors.forename: Chung-Hwan
authors.initials: CH
authors.lastname: Baek
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy; D016019:Survival Analysis; D014062:Tongue Neoplasms / Q000473:pathology*
keywords: Cancer; Head and neck; Metastasis; Sentinel lymph node; Surgery