Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinoma: Cohort study and meta-analysis

Objectives: To evaluate the efficacy of sentinel node biopsy (SNB) in oral squamous cell carcinoma (OSCC). Design: A prospective study of a cohort of 25 consecutive patients with OSCC anatomopathological confirmation through biopsy, without oncological pre-treatment, in clinical stage T1-T4N0, of these 25 patients 14 were T1-T2N0. The absence of regional disease (N0) was determined by means of clinical exploration and cervical tomography (CT). To establish the overall sensitivity of the technique, a meta-analysis was carried out of 10 series published to February 2005 where SNB had been applied to head and neck cancer, adding our 14 T1-T2N0 cases, thus making a total of 260 patients. Results: Identification by SNB was accurate in 96% of the 25 cases, with a sensitivity of 66.7%. Analyzing only the T1-T2N0 cases (n=14), the accuracy was 100% with a sensitivity of 1 (CI 95%, 0.29-1.00). The overall sensitivity was 93%. The accuracy in identifying the sentinel node varied between 66% and 100%. The SN was identified in 251 of 260 cases, of those, 71 were true positive, 5 false negative and 175 true negative. The overall sensitivity was 93.4% (CI 95%, 85.3-97.8), with a specificity of 100% (CI 95%, 0.98-100). The weighted negative probability quotient was 0.176 (CI 0.103-0.301) and that of positive probability 24.75 (CI 95%, 10.8-56.71). The weighted diagnostic odds ratio was 183.71 (CI 95%, 59.36-568.56). If we accept that the prevalence of hidden regional disease is 30%, a negative sentinel node has 5% possibility of having hidden disease. Conclusions: Our data provide a certain degree of evidence that, due to its high sensitivity, the SNB procedure can be applied to the initial stages of OSCC.

Bibliographic Details

Main Authors:	Alvarez Amézaga,Julio, Barbier Herrero,Luis, Pijoan del Barrio,José I., Martín Rodríguez,Jesús C., Romo Simón,Laura, Genolla Subirats,José, Rios Altolaguirre,Gonzalo, Ríos,Antonio de los, Arteagoitia Calvo,Icíar, Landa Llona,Salvador, Arruti González,Jose A., López Cedrún,José, Santamaría Zuazua,Joseba
Format:	Digital revista
Language:	English
Published:	Sociedad Española de Medicina Oral 2007
Online Access:	http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1698-69462007000300014
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