Sentinel lymph node biopsy as an alternative to wait and see policy in patients with small T1 oral cavity squamous cell carcinoma

Abstract

Conclusion. Although sentinel lymph node (SLN) biopsy is not yet validated for clinical use to replace elective neck dissection in patients with oral squamous cell carcinoma, it can be recommended for patients who do not fulfil the criteria for elective neck treatment according to current treatment protocols. Objective. To examine the benefits of SLN biopsy in oral cancer patients who have a small risk for occult metastasis and therefore are not considered candidates for elective neck treatment. Patients and methods. Thirteen consecutive patients with a small T1 oral cavity squamous cell carcinoma, clinically staged N0, and who did not meet the indications for elective neck treatment, underwent SLN biopsy. The SLNs were cut at 1–2 mm intervals and stained with haematoxylin and eosin and cytokeratin AE1/AE3. Results. Histopathological examination of SLNs revealed micrometastases in two patients. A selective neck dissection was performed on these patients and no further metastases were encountered. All patients had a minimum follow-up of 12 months and no cervical or other recurrences were encountered.