title: Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer.
abstract: OBJECTIVE
  Optimum management of the N0 neck is unresolved in oral cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis. The object of this study was to establish whether the technique was both reliable in staging the N0 neck and a safe oncological procedure in patients with early-stage oral squamous cell carcinoma.
  
  
  METHODS
  An European Organisation for Research and Treatment of Cancer-approved prospective, observational study commenced in 2005. Fourteen European centres recruited 415 patients with radiologically staged T1-T2N0 squamous cell carcinoma. SNB was undertaken with an average of 3.2 nodes removed per patient. Patients were excluded if the sentinel node (SN) could not be identified. A positive SN led to a neck dissection within 3 weeks. Analysis was performed at 3-year follow-up.
  
  
  RESULTS
  An SN was found in 99.5% of cases. Positive SNs were found in 23% (94 in 415). A false-negative result occurred in 14% (15 in 109) of patients, of whom eight were subsequently rescued by salvage therapy. Recurrence after a positive SNB and subsequent neck dissection occurred in 22 patients, of which 16 (73%) were in the neck and just six patients were rescued. Only minor complications (3%) were reported following SNB. Disease-specific survival was 94%. The sensitivity of SNB was 86% and the negative predictive value 95%.
  
  
  CONCLUSIONS
  These data show that SNB is a reliable and safe oncological technique for staging the clinically N0 neck in patients with T1 and T2 oral cancer. EORTC Protocol 24021: Sentinel Node Biopsy in the Management of Oral and Oropharyngeal Squamous Cell Carcinoma.
authors.affiliation: Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK.
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authors.initials: C
authors.lastname: Schilling
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery Kantonsspital St Gallen, Switzerland.
authors.forename: Sandro J
authors.initials: SJ
authors.lastname: Stoeckli
authors.affiliation: Department of Head and Neck Surgery, University of Basel, Switzerland.
authors.forename: Stephan K
authors.initials: SK
authors.lastname: Haerle
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery Kantonsspital St Gallen, Switzerland.
authors.forename: Martina A
authors.initials: MA
authors.lastname: Broglie
authors.affiliation: Department of Otolaryngology University Hospital Zurich, Switzerland.
authors.forename: Gerhard F
authors.initials: GF
authors.lastname: Huber
authors.affiliation: Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark.
authors.forename: Jens Ahm
authors.initials: JA
authors.lastname: Sorensen
authors.affiliation: Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark.
authors.forename: Vivi
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authors.lastname: Bakholdt
authors.affiliation: Department of Pathology, Odense University Hospital, Denmark.
authors.forename: Annelise
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authors.lastname: Krogdahl
authors.affiliation: Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: von Buchwald
authors.affiliation: Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Anders
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authors.lastname: Bilde
authors.affiliation: Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars R
authors.initials: LR
authors.lastname: Sebbesen
authors.affiliation: Head and Neck/Oral Pathology, King's College London, Guys and St Thomas NHS Trust, London, UK.
authors.forename: Edward
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authors.lastname: Odell
authors.affiliation: Department of Head and Neck Surgery, Guys and St Thomas NHS Trust, London, UK.
authors.forename: Benjamin
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authors.lastname: Gurney
authors.affiliation: Department of Nuclear Medicine, Guys and St Thomas NHS Trust, London, UK.
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authors.affiliation: Department of Otolaryngology Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
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authors.affiliation: Department of Pathology, VU University Medical Centre and Academic Centre of Dentistry Amsterdam, The Netherlands.
authors.forename: Elisabeth
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authors.affiliation: Department of Otolaryngology Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Geke B
authors.initials: GB
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authors.affiliation: Department of Maxillofacial Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Pedro M
authors.initials: PM
authors.lastname: Villarreal
authors.affiliation: Department of Pathology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Manuel Florentino
authors.initials: MF
authors.lastname: Fresno Forcelledo
authors.affiliation: Department of Maxillofacial Surgery, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Luis Manuel
authors.initials: LM
authors.lastname: Junquera Gutiérrez
authors.affiliation: Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain.
authors.forename: Julio Alvarez
authors.initials: JA
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authors.affiliation: Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain.
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authors.affiliation: Department of Maxillofacial Surgery, BioCruces, Hospital Universitario De Cruces, Universidad del Pais Vasco (UPV/EHU), Bilbao, Spain.
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authors.affiliation: Department of Head and Neck Surgery, Instituto Portugues de Oncologia do Porto, Portugal.
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authors.affiliation: Department of Head and Neck Surgery, Instituto Portugues de Oncologia do Porto, Portugal.
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authors.affiliation: Department of Otorhinolaryngology, San Carlo Hospital Rome, Italy.
authors.forename: Maurizio Giovanni
authors.initials: MG
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authors.affiliation: Department of Histopathology, San Carlo Hospital Rome, Italy.
authors.forename: Siavash
authors.initials: S
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authors.affiliation: Department of Nuclear Medicine, Cristo Re Hospital, Rome, Italy.
authors.forename: Girolamo
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authors.affiliation: Department of Head and Neck Surgery, CHU Dinant Godinne, Université Catholique de Louvain, Belgium.
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authors.affiliation: Department of Head and Neck Surgery, CHU Dinant Godinne, Université Catholique de Louvain, Belgium.
authors.forename: Marie-Cecile
authors.initials: MC
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authors.affiliation: Department of Otolaryngology, Ospedale S. Chiara, Trento, Italy.
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authors.affiliation: Department of Nuclear Medicine, Ospedale S. Chiara, Trento, Italy.
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authors.affiliation: Department of Surgical Pathology, Ospedale S. Chiara, Trento, Italy.
authors.forename: Emma
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authors.lastname: Bragantini
authors.affiliation: Department of Maxillofacial Surgery CHU de Charleroi Belgium, Belgium.
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authors.affiliation: Department of Maxillofacial Surgery CHU de Charleroi Belgium, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lothaire
authors.affiliation: Department of Maxillofacial Surgery, Azienda Ospedaliera, Universitaria of Parma, Italy.
authors.forename: Tito
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authors.affiliation: Department of Pathology Azienda Ospedaliera Universitaria of Parma, Italy.
authors.forename: Enrico M
authors.initials: EM
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authors.affiliation: Department of Maxillofacial Surgery, Azienda Ospedaliera, Universitaria of Parma, Italy.
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authors.affiliation: Department of Head and Neck Surgery Centre Alexis Vautrin, Vandoeuvre Les Nancy, France.
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authors.affiliation: Department of Head and Neck Surgery Centre Alexis Vautrin, Vandoeuvre Les Nancy, France.
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authors.affiliation: Department of Pathology Centre Alexis Vautrin, Vandoeuvre Les Nancy, France.
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authors.affiliation: Department of Informatics, Kings' College London, UK.
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mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D005060:Europe; D005188:False Negative Reactions; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D037981:Neck Dissection; D061206:Neoplasm Micrometastasis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects; D000077195:Squamous Cell Carcinoma of Head and Neck; D013997:Time Factors; D016896:Treatment Outcome
keywords: Lymphoscintigraphy; Metastasis; Micrometastasis; Oral Cancer; Recurrence; Sentinel lymph node biopsy