Reliability of sentinel lymph node biopsy in head and neck squamous cell carcinoma

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<p class="abstract"><strong>Background:</strong> The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph node is the target organs primarily reached by metastasizing cancer cells from the tumor. Thus, sentinel lymph nodes can be totally void of cancer, due to the fact that they were detected prior to dissemination. Sentinel node biopsy is considered to be the gold standard investigation tool for the detection of lymph node metastases in head and neck squamous cell carcinoma.</p><p class="abstract"><strong>Methods:</strong> Sentinel node mapping uses one or all of the following three :(1) radioisotope scan imaging (2) injection of blue dye (3) use of a handheld isotope tracer probe for localization, it has been shown that the combination of all three techniques increases the accuracy and the yield of sentinel lymph node identification.</p><p class="abstract"><strong>Results:</strong> Sentinel lymph node biopsy should be recommended only in patients with previously untreated early stage (T1/2) oral cavity and oropharynx cancer with clinical N0 stage. Sentinel node radio localization in head and neck squamous cell carcinoma may potentially reduce the time, cost, and morbidity of regional lymph node management.</p><strong>Conclusions:</strong> Sentinel node biopsy is a reliable means of staging the clinically N0 neck for patients with cT1/T2 head and neck squamous cell carcinoma. It can be used as the sole staging tool for the majority of patients.