title: Sentinel lymph node biopsy reduces the incidence of secondary neck metastasis in patients with oral squamous cell carcinoma.
abstract: It has recently been established that sentinel node biopsy (SNB) is an applicable and feasible procedure for the prediction of neck lymph node status in patients with early oral squamous cell carcinoma (OSCC) who are clinically negative for neck metastasis (cN0). The aim of this study was to retrospectively compare excision followed by watchful waiting with excision and SNB, in order to determine the effectiveness of SNB. A total of 125 patients with cN0 early OSCC were divided into two groups, namely the excision alone (n=78) and excision with SNB (n=47) groups. The clinical data of these two groups between 2006 and 2013 were analyzed. In the excision with SNB group, the negative predictive value and false-negative rate of SNB were 94% (30/32) and 18% (2/11), respectively. Secondary neck metastasis, also known as delayed neck metastasis, occurred in 24.2% of the patients in the excision alone group and 4.9% of the patients in the excision with SNB group. The 5-year overall survival (OS) rates were 84.0 and 97.5% in the excision alone and excision with SNB groups, respectively. Significant differences were found in the rate of secondary neck metastasis and OS between the two groups. SNB may be effective in the detection of occult neck lymph node metastasis, with a reduction in the incidence of secondary neck metastasis and improvements in the 5-year OS in patients with early-stage (stage I/II) oral cancer.
authors.affiliation: Division of Oral Oncology, Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka 814-0193, Japan.
authors.forename: Akimitsu
authors.initials: A
authors.lastname: Hiraki
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Fukuma
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Nagata
authors.affiliation: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Shiraishi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Kawahara
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Matsuoka
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Yoshida
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Itoh Dento-Maxillofacial Hospital, Kumamoto 860-8556, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yoshitake
authors.affiliation: Itoh Dento-Maxillofacial Hospital, Kumamoto 860-8556, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Shinohara
authors.affiliation: Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakayama
keywords: biopsy; delayed neck metastasis; elective neck dissection; oral squamous cell carcinoma; secondary neck metastasis; sentinel lymph node; watchful waiting