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Open AccessArticle

Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience

1
Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
2
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
3
Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
4
Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
5
Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC/Academic Centre for Dentistry (ACTA), 1081 HV Amsterdam, The Netherlands
6
Department of Pathology, Amsterdam UMC (location VU Medical Center), 1081 HV Amsterdam, The Netherlands
7
Department of Nuclear Medicine, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
8
Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
9
Department of Head and Neck Surgery, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
10
Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC (location VU University Medical Center), 1081 HV Amsterdam, The Netherlands
11
Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
12
Department of Pathology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
13
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
*
Author to whom correspondence should be addressed.
Both authors contributed equally to this study.
Cancers 2020, 12(7), 1783; https://doi.org/10.3390/cancers12071783
Received: 24 May 2020 / Revised: 28 June 2020 / Accepted: 30 June 2020 / Published: 3 July 2020
Background: Sentinel lymph node biopsy (SLNB) has been introduced as a diagnostic staging modality for detection of occult metastases in patients with early stage oral cancer. Comparisons regarding accuracy to the routinely used elective neck dissection (END) are lacking in literature. Methods: A retrospective, multicenter cohort study included 390 patients staged by END and 488 by SLNB. Results: The overall sensitivity (84% vs. 81%, p = 0.612) and negative predictive value (NPV) (93%, p = 1.000) were comparable between END and SLNB patients. The END cohort contained more pT2 tumours (51%) compared to the SLNB cohort (23%) (p < 0.001). No differences were found for sensitivity and NPV between SLNB and END divided by pT stage. In floor-of-mouth (FOM) tumours, SLNB had a lower sensitivity (63% vs. 92%, p = 0.006) and NPV (90% vs. 97%, p = 0.057) compared to END. Higher disease-specific survival (DSS) rates were found for pT1 SLNB patients compared to pT1 END patients (96% vs. 90%, p = 0.048). Conclusion: In the absence of randomized clinical trials, this study provides the highest available evidence that, in oral cancer, SLNB is as accurate as END in detecting occult lymph node metastases, except for floor-of-mouth tumours. View Full-Text
Keywords: oral cancer; lymph node metastases; sentinel lymph node biopsy; elective neck dissection; lymphatics oral cancer; lymph node metastases; sentinel lymph node biopsy; elective neck dissection; lymphatics
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MDPI and ACS Style

den Toom, I.J.; Boeve, K.; Lobeek, D.; Bloemena, E.; Donswijk, M.L.; de Keizer, B.; Klop, W.M.C.; Leemans, C.R.; Willems, S.M.; Takes, R.P.; Witjes, M.J.H.; de Bree, R. Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience. Cancers 2020, 12, 1783. https://doi.org/10.3390/cancers12071783

AMA Style

den Toom IJ, Boeve K, Lobeek D, Bloemena E, Donswijk ML, de Keizer B, Klop WMC, Leemans CR, Willems SM, Takes RP, Witjes MJH, de Bree R. Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience. Cancers. 2020; 12(7):1783. https://doi.org/10.3390/cancers12071783

Chicago/Turabian Style

den Toom, Inne J.; Boeve, Koos; Lobeek, Daphne; Bloemena, Elisabeth; Donswijk, Maarten L.; de Keizer, Bart; Klop, W. M.C.; Leemans, C. R.; Willems, Stefan M.; Takes, Robert P.; Witjes, Max J.H.; de Bree, Remco. 2020. "Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience" Cancers 12, no. 7: 1783. https://doi.org/10.3390/cancers12071783

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