Neck Dissections Based on Sentinel Lymph Node Navigation Versus Elective Neck Dissections in Early Oral Cancers: A...

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Early-stage oral cavity squamous cell carcinoma (OCSCC) management often involves elective neck dissection (ND).
• Sentinel lymph node biopsy (SLNB) is an alternative staging procedure for the neck, potentially reducing morbidity.

Purpose of the Study:

• To compare the efficacy and safety of SLNB-navigated ND versus traditional elective ND in patients with early OCSCC.
• To evaluate survival rates, neck function, and postoperative complications as primary and secondary endpoints.

Main Methods:

• A randomized trial involving 16 institutions in Japan with T1-2, node-negative OCSCC patients (N=271).
• Patients were assigned to either standard elective ND (n=137) or SLNB-navigated ND (n=134).
• Primary endpoint was 3-year overall survival; secondary endpoints included disease-free survival and neck functionality.

Main Results:

• 3-year overall survival was non-inferior between SLNB (87.9%) and ND (86.6%) groups (P < .001).
• 3-year disease-free survival was also comparable (SLNB: 78.7%, ND: 81.3%; P < .001).
• Patients undergoing SLNB-navigated ND demonstrated significantly better neck functionality post-surgery.

Conclusions:

• SLNB-navigated ND is a safe and effective alternative to elective ND for early-stage OCSCC.
• This approach achieves comparable survival outcomes while enhancing postoperative neck function and reducing disability.