Display options
Cite
Boeve K, Schepman KP, Schuuring E, et al. High sensitivity and negative predictive value of sentinel lymph node biopsy in a retrospective early stage oral cavity cancer cohort in the Northern Netherlands. Clin Otolaryngol. 2018;43(4):1080-1087doi: 10.1111/coa.13107.
Boeve, K., Schepman, K. P., Schuuring, E., Roodenburg, J. L. N., Halmos, G. B., van Dijk, B. A. C., Boorsma, R. A. C., de Visscher, J. G. A. M., Brouwers, A. H., van der Vegt, B., & Witjes, M. J. H. (2018). High sensitivity and negative predictive value of sentinel lymph node biopsy in a retrospective early stage oral cavity cancer cohort in the Northern Netherlands. Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 43(4), 1080-1087. https://doi.org/10.1111/coa.13107
Boeve, K, et al. "High sensitivity and negative predictive value of sentinel lymph node biopsy in a retrospective early stage oral cavity cancer cohort in the Northern Netherlands." Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery vol. 43,4 (2018): 1080-1087. doi: https://doi.org/10.1111/coa.13107
Boeve K, Schepman KP, Schuuring E, Roodenburg JLN, Halmos GB, van Dijk BAC, Boorsma RAC, de Visscher JGAM, Brouwers AH, van der Vegt B, Witjes MJH. High sensitivity and negative predictive value of sentinel lymph node biopsy in a retrospective early stage oral cavity cancer cohort in the Northern Netherlands. Clin Otolaryngol. 2018 Aug;43(4):1080-1087. doi: 10.1111/coa.13107. Epub 2018 Apr 19. PMID: 29575685.
Copy Download .nbib Format: NLM
Share it on

Clin Otolaryngol. 2018 Aug;43(4):1080-1087. doi: 10.1111/coa.13107. Epub 2018 Apr 19.

High sensitivity and negative predictive value of sentinel lymph node biopsy in a retrospective early stage oral cavity cancer cohort in the Northern Netherlands.

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

K Boeve, K P Schepman, E Schuuring, J L N Roodenburg, G B Halmos, B A C van Dijk, R A C Boorsma, J G A M de Visscher, A H Brouwers, B van der Vegt, M J H Witjes

Affiliations

  1. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  2. Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  3. Department of Otorhinolaryngology/Head & Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  4. Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  5. Department of Research, Comprehensive Cancer Organization The Netherlands (IKNL), Utrecht, The Netherlands.
  6. Pathologie Friesland, Leeuwarden, The Netherlands.
  7. Department of Oral and Maxillofacial Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
  8. Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

PMID: 29575685 DOI: 10.1111/coa.13107

Abstract

OBJECTIVES: In cT1-2N0, oral squamous cell carcinoma (OSCC) occult metastases are detected in 23%-37% of cases. Sentinel lymph node biopsy (SLNB) was introduced in head and neck cancer as a minimally invasive alternative for an elective neck dissection in neck staging. Meta-analyses of SLNB accuracy show heterogeneity in the existing studies for reference standards, imaging techniques and pathological examination. The aim of this study was to assess the sensitivity and negative predictive value (NPV) of the SLNB in detecting occult metastases in cT1-2N0 OSCC in a well-defined cohort.

DESIGN: Retrospective study. The SLNB procedure consisted of lymphoscintigraphy, SPECT/CT-scanning and gamma probe detection. Routine follow-up was the reference standard for the SLNB negative neck. Histopathological examination of sentinel lymph nodes (SLN) consisted of step serial sectioning, haematoxylin-eosin and cytokeratin AE1/3 staining.

SETTING: Two comprehensive oncology centres.

PARTICIPANTS: A total of 91 consecutive patients with primary cT1-2N0 OSCC treated by primary resection and neck staging by SLNB procedure between 2008 and 2016.

MAIN OUTCOME MEASURES: Sensitivity and negative predictive value.

RESULTS: In all cases, SLNs were harvested. A total of 25 (27%) patients had tumour-positive SLNs. The median follow-up was 32 months (range 2-104). Four patients were diagnosed with an isolated regional recurrence in the SLNB negative neck side resulting in an 85% sensitivity and a 94% NPV.

CONCLUSION: In our cohort, the SLNB detected occult metastases in early OSCC with 85% sensitivity and 94% NPV. This supports that SLNB is a reliable procedure for surgical staging of the neck in case of oral cT1-2N0 SCC.

© 2018 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd.

Keywords: head and neck cancer; lymphoscintigraphy; oral cancer; predictive value of tests; sensitivity and specificity; sentinel lymph node biopsy; squamous cell carcinoma

References

  1. Schilling C, Stoeckli SJ, Haerle SK, et al. Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer. 2015;51:2777-2784. - PubMed
  2. Broglie MA, Haile SR, Stoeckli SJ. Long-term experience in sentinel node biopsy for early oral and oropharyngeal squamous cell carcinoma. Ann Surg Oncol. 2011;18:2732-2738. - PubMed
  3. Ganly I, Patel S, Shah J. Early stage squamous cell cancer of the oral tongue-clinicopathologic features affecting outcome. Cancer. 2012;118:101-111. - PubMed
  4. Larsen SR, Johansen J, Sorensen JA, Krogdahl A. The prognostic significance of histological features in oral squamous cell carcinoma. J Oral Pathol Med. 2009;38:657-662. - PubMed
  5. de Bree R, Nieweg OE. The history of sentinel node biopsy in head and neck cancer: from visualization of lymphatic vessels to sentinel nodes. Oral Oncol. 2015;51:819-823. - PubMed
  6. Pedersen NJ, Jensen DH, Hedback N, et al. Staging of early lymph node metastases with the sentinel lymph node technique and predictive factors in T1/T2 oral cavity cancer: a retrospective single-center study. Head Neck. 2016;38(Suppl 1):E1033-E1040. - PubMed
  7. Flach GB, Bloemena E, Klop WM, et al. Sentinel lymph node biopsy in clinically N0 T1-T2 staged oral cancer: the Dutch multicenter trial. Oral Oncol. 2014;50:1020-1024. - PubMed
  8. Den Toom IJ, Heuveling DA, Flach GB, et al. Sentinel node biopsy for early-stage oral cavity cancer: the VU University Medical Center experience. Head Neck. 2015;37:573-578. - PubMed
  9. van den Brekel MW, Castelijns JA, Stel HV, Golding RP, Meyer CJ, Snow GB. Modern imaging techniques and ultrasound-guided aspiration cytology for the assessment of neck node metastases: a prospective comparative study. Eur Arch Otorhinolaryngol. 1993;250:11-17. - PubMed
  10. Schoder H, Carlson DL, Kraus DH, et al. 18F-FDG PET/CT for detecting nodal metastases in patients with oral cancer staged N0 by clinical examination and CT/MRI. J Nucl Med. 2006;47:755-762. - PubMed
  11. Woolgar JA, Beirne JC, Vaughan ED, Lewis-Jones HG, Scott J, Brown JS. Correlation of histopathologic findings with clinical and radiologic assessments of cervical lymph-node metastases in oral cancer. Int J Oral Maxillofac Surg. 1995;24(1 Pt 1):30-37. - PubMed
  12. D'Cruz AK, Vaish R, Kapre N, et al. Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med. 2015;373:521-529. - PubMed
  13. Teymoortash A, Hoch S, Eivazi B, Werner JA. Postoperative morbidity after different types of selective neck dissection. Laryngoscope. 2010;120:924-929. - PubMed
  14. Chone CT, Aniteli MB, Magalhaes RS, et al. Impact of immunohistochemistry in sentinel lymph node biopsy in head and neck cancer. Eur Arch Otorhinolaryngol. 2013;270:313-317. - PubMed
  15. Liu M, Wang SJ, Yang X, Peng H. Diagnostic efficacy of sentinel lymph node biopsy in early oral squamous cell carcinoma: a meta-analysis of 66 studies. PLoS ONE. 2017;12:e0170322. - PubMed
  16. Dutch Central Committee on Research Involving Human Subjects. http://www.ccmo.nl/en/non-wmo-research. Accessed August 11, 2017. - PubMed
  17. Dutch guideline head and neck cancer 2014. https://www.nvmka.nl/sites/www.nvmka.nl/files/Richtlijn%20Hoofd-halstumoren%202015.pdf. Accessed March 30, 2017. - PubMed
  18. Boeve K, Schepman KP, Vegt BV, et al. Lymphatic drainage patterns of oral maxillary tumors: approachable locations of sentinel lymph nodes mainly at the cervical neck level. Head Neck. 2017;39:486-491. - PubMed
  19. Pezier T, Nixon IJ, Gurney B, et al. Sentinel lymph node biopsy for T1/T2 oral cavity squamous cell carcinoma-a prospective case series. Ann Surg Oncol. 2012;19:3528-3533. - PubMed
  20. Weiss MH, Harrison LB, Isaacs RS. Use of decision analysis in planning a management strategy for the stage N0 neck. Arch Otolaryngol Head Neck Surg. 1994;120:699-702. - PubMed
  21. Alkureishi LW, Ross GL, Shoaib T, et al. Sentinel node biopsy in head and neck squamous cell cancer: 5-year follow-up of a European multicenter trial. Ann Surg Oncol. 2010;17:2459-2464. - PubMed
  22. Civantos FJ, Zitsch RP, Schuller DE, et al. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010;28:1395-1400. - PubMed
  23. Stoeckli SJ, Huebner T, Huber GF, Broglie MA. Technique for reliable sentinel node biopsy in squamous cell carcinomas of the floor of mouth. Head Neck. 2016;38:1367-1372. - PubMed
  24. van den Berg NS, Brouwer OR, Klop WM, et al. Concomitant radio- and fluorescence-guided sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity using ICG-(99 m)Tc-nanocolloid. Eur J Nucl Med Mol Imaging. 2012;39:1128-1136. - PubMed
  25. Den Toom IJ, Bloemena E, van Weert S, Karagozoglu KH, Hoekstra OS, de Bree R. Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes. Eur Arch Otorhinolaryngol. 2017;274:961-968. - PubMed
  26. Stoeckli SJ, Pfaltz M, Ross GL, et al. The second international conference on sentinel node biopsy in mucosal head and neck cancer. Ann Surg Oncol. 2005;12:919-924. - PubMed
  27. Jefferson GD, Sollaccio D, Gomez-Fernandez CR, Civantos F Jr. Evaluation of immunohistochemical fine sectioning for sentinel lymph node biopsy in oral squamous cell carcinoma. Otolaryngol Head Neck Surg. 2011;144:216-219. - PubMed
  28. Bell RB, Markiewicz MR, Dierks EJ, Gregoire CE, Rader A. Thin serial step sectioning of sentinel lymph node biopsy specimen may not be necessary to accurately stage the neck in oral squamous cell carcinoma. J Oral Maxillofac Surg. 2013;71:1268-1277. - PubMed
  29. Te Grootenhuis NC, van der Zee AG, van Doorn HC, et al. Sentinel nodes in vulvar cancer: long-term follow-up of the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I. Gynecol Oncol. 2016;140:8-14. - PubMed
  30. Slomovitz BM, Coleman RL, Oonk MH, van der Zee A, Levenback C. Update on sentinel lymph node biopsy for early-stage vulvar cancer. Gynecol Oncol. 2015;138:472-477. - PubMed
  31. Van der Zee AG, Oonk MH, De Hullu JA, et al. Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol. 2008;26:884-889. - PubMed
  32. Hermanek P, Hutter RV, Sobin LH, Wittekind C. International Union against cancer. Classification of isolated tumor cells and micrometastasis. Cancer. 1999;86:2668-2673. - PubMed
  33. Turrentine FE, Wang H, Simpson VB, Jones RS. Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg. 2006;203:865-877. - PubMed
  34. Melkane AE, Mamelle G, Wycisk G, et al. Sentinel node biopsy in early oral squamous cell carcinomas: a 10-year experience. Laryngoscope. 2012;122:1782-1788. - PubMed
  35. Melchers LJ, Schuuring E, van Dijk BA, et al. Tumour infiltration depth >/=4 mm is an indication for an elective neck dissection in pT1cN0 oral squamous cell carcinoma. Oral Oncol. 2012;48:337-342. - PubMed
  36. Clausen MJ, Melchers LJ, Mastik MF, et al. RAB25 expression is epigenetically downregulated in oral and oropharyngeal squamous cell carcinoma with lymph node metastasis. Epigenetics. 2016;11:653-663. - PubMed
  37. Clausen MJ, Melchers LJ, Mastik MF, et al. Identification and validation of WISP1 as an epigenetic regulator of metastasis in oral squamous cell carcinoma. Genes Chromosom Cancer. 2016;55:45-59. - PubMed
  38. van der Gun BT, Melchers LJ, Ruiters MH, de Leij LF, McLaughlin PM, Rots MG. EpCAM in carcinogenesis: the good, the bad or the ugly. Carcinogenesis. 2010;31:1913-1921. - PubMed

Publication Types