Sentinel node biopsy as an alternative to elective neck dissection for staging of early oral carcinoma

BackgroundWe report the outcome of sentinel node biopsy (SNB) for staging the neck in a consecutive cohort of 34 patients with T1/2 clinically N0 oral carcinoma. MethodsSNB was performed along with resection of primary tumor. Neck dissection was reserved for failure of SNB or pathologically positive sentinel nodes (pN+). ResultsSentinel node identification was successful in 32 of 34 patients (94%); 2 patients with unsuccessful SNB underwent immediate neck dissection. Seven patients (21%) were pN+, 6 by SNB and 1 by elective neck dissection (END). Among 29 patients who were pN0 on SNB, nodal recurrence developed in 2 patients; both were surgically salvaged. Local failure developed in 1 patient. Two-year overall and disease-free survival was 87% and 80%, respectively. ConclusionSuccessful eradication of lymphatic metastasis noted in this study suggests that SNB may be a safe alternative to END for neck staging in patients with early oral carcinoma. (c) 2013 Wiley Periodicals, Inc. Head Neck 36: 241-246, 2014