Sentinel node biopsy for early oral carcinoma

Area of Science:

• Oncology
• Surgical Pathology

Background:

• Sentinel node biopsy (SNB) has been investigated for over a decade in oral squamous cell carcinomas (OSCCs).
• Growing evidence supports SNB as a viable alternative to elective neck dissection for staging early-stage OSCC.

Purpose of the Study:

• To review recent advancements and validate the role of SNB in staging early-stage OSCC.
• To assess the accuracy, safety, and efficacy of SNB compared to elective neck dissection.

Main Methods:

• Analysis of a large-scale multicentric validation trial and long-term follow-ups.
• Evaluation of histologic and molecular parameters for predicting occult neck disease.
• Utilizing step-serial sectioning and immunohistochemistry for accurate staging.

Main Results:

• Recent trials confirm the accuracy, safety, and efficacy of SNB for staging cN0 early-stage OSCC.
• SNB demonstrates superiority over elective neck dissection, with significantly lower complication rates.
• Quantitative real-time reverse transcriptase-polymerase chain reaction enables rapid intraoperative assessment, facilitating a one-stage procedure.

Conclusions:

• SNB is a minimally invasive, highly reliable staging method for the cN0 neck in OSCC.
• It has become the standard of care in many institutions globally.
• Recent developments are expanding its clinical application and acceptance.