1
|
Abbaci M, Villard A, Auperin A, Asmandar S, Moya-Plana A, Casiraghi O, Breuskin I. Ultra-fast confocal fluorescence microscopy for neck lymph node imaging in head and neck cancer. Oral Oncol 2024; 154:106862. [PMID: 38820885 DOI: 10.1016/j.oraloncology.2024.106862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 05/16/2024] [Accepted: 05/18/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES We evaluated ultra-fast confocal fluorescence microscopy (UFCM) as a new modality for pathology practice in head and neck cancer (HNC). This was assessed through an ex vivo study to estimate the accuracy, specificity, and sensitivity of interpretation of UFCM images by pathologists for the detection of metastatic lymph nodes in HNC patients undergoing sentinel lymph node biopsy or selective or complete neck dissection. MATERIALS AND METHODS 44 patients with 32 cN0 and 12 cN+ HNC were included. The macroscopically non-invaded fresh bisected lymph nodes were stained with acridine orange and imaged with Histolog® Scanner (UFCM). Two pathologists interpreted independently the UFCM images postoperatively and gave a consensus diagnosis in case of disagreement. The gold standard was the diagnosis based on hematoxylin-eosin-saffron (HES) sections. RESULTS 201 lymph nodes were imaged by UFCM. Thirty nodes (15 %) were invaded on final histology: 3 with micrometastases and 27 with macrometastases. The concordance rate between the pathologists on the UFCM images was 192/201 = 95.5 % and the Cohen kappa coefficient was 0.80. The accuracy of UFCM was 95.5 % (95 %CI: 91.7 %-97.9 %) with a high specificity at 98.8 % (95 %CI: 95.8 %-99.9 %) but an insufficient sensitivity at 76.7 % (95 %CI: 57.7 %-90.1 %). The three micrometastases and four of the 27 macrometastases were missed on UFCM images. CONCLUSION The UFCM is providing promising detection values with a very good specificity and moderate sensitivity carrying room for improvement.
Collapse
Affiliation(s)
- Muriel Abbaci
- Gustave Roussy, Plate-forme Imagerie et Cytométrie, UMS 23/3655, Université Paris-Saclay, Villejuif, France; Gustave Roussy, Surgery and Pathology Photonic Imaging group, Villejuif, France.
| | - Adrien Villard
- Gustave Roussy, Surgery and Pathology Photonic Imaging group, Villejuif, France; Gustave Roussy, Département de Cancérologie et de chirurgie Cervico-Faciale, Université Paris-Saclay, Villejuif, France
| | - Anne Auperin
- Gustave Roussy, Service de Biostatistique et d'Epidémiologie, Université Paris-Saclay, Villejuif, France; Oncostat CESP - Labeled Ligue Contre le Cancer, INSERM 1018, Université Paris-Saclay, UVSQ, Villejuif, France
| | - Safaa Asmandar
- Gustave Roussy, Département de Biologie et Pathologie Médicale, Université Paris-Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Gustave Roussy, Département de Cancérologie et de chirurgie Cervico-Faciale, Université Paris-Saclay, Villejuif, France
| | - Odile Casiraghi
- Gustave Roussy, Surgery and Pathology Photonic Imaging group, Villejuif, France; Gustave Roussy, Département de Biologie et Pathologie Médicale, Université Paris-Saclay, Villejuif, France
| | - Ingrid Breuskin
- Gustave Roussy, Surgery and Pathology Photonic Imaging group, Villejuif, France; Gustave Roussy, Département de Cancérologie et de chirurgie Cervico-Faciale, Université Paris-Saclay, Villejuif, France
| |
Collapse
|
2
|
Lam V, O'Brien O, Amin O, Nigar E, Kumar M, Lingam RK. Oral cavity cancer and its pre-treatment radiological evaluation: A pictorial overview. Eur J Radiol 2024; 176:111494. [PMID: 38776803 DOI: 10.1016/j.ejrad.2024.111494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Oral cavity cancer, primarily squamous cell carcinoma (SCC), is a prevalent malignancy globally, necessitating accurate clinical assessment and staging to enable effective treatment planning. Diagnosis requires biopsy and is followed by surgical resection and reconstruction as the primary therapeutic modality. Imaging plays a pivotal role during this process, aiding in the evaluation of tumour extent, nodal involvement and distant metastases. However, despite its value, both radiologists and clinicians must recognise its inherent limitations. METHODS This pictorial review article aims to illustrate the application of various imaging modalities in the pre-treatment evaluation of oral cavity SCC and highlights potential pitfalls. It underscores the importance of understanding the anatomical subsites of the oral cavity, the diverse patterns of spread tumours exhibit at each site, alongside the role of imaging in facilitating informed management strategies, while also acknowledging its limitations. RESULTS The review delves into fundamentals of current staging including nodal involvement, while, emphasising imaging strategies and potential limitations. Finally, it touches on the potential of novel radiomic techniques in characterising tumours and predicting treatment response. CONCLUSIONS Pre-treatment oral cavity cancer staging reflects an ongoing quest for enhanced diagnostic accuracy and prognostic prediction. Recognising the value of imaging alongside its limitations fosters a multidisciplinary approach to treatment planning, ultimately improving patient outcomes.
Collapse
Affiliation(s)
- Vincent Lam
- Department of Radiology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, United Kingdom
| | - Owen O'Brien
- Department of Radiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom
| | - Omed Amin
- Department of Radiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom; Department of Radiology, Chelsea and Westminster NHS Foundation Trust, 369 Fulham Rd, London SW10 9NH, United Kingdom
| | - Ezra Nigar
- Department of Pathology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom
| | - Mahesh Kumar
- Department of Oral and Maxillofacial Surgery, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom; Department of Oral and Maxillofacial Surgery, Hillingdon Hospital, The Hillingdon Hospitals NHS Foundation Trust, Pield Heath Rd, Uxbridge UB8 3NN, United Kingdom
| | - Ravi Kumar Lingam
- Department of Radiology, Northwick Park Hospital, London North West University Healthcare NHS Trust, Watford Road, London HA1 3UJ, United Kingdom.
| |
Collapse
|
3
|
Stenz NA, Morand GB, Schoch M, Werner J, Rajan GP. Use of Indocyanine Green Near-Infrared Imaging for Sentinel Lymph Node Biopsy in Early Oral Squamous Cell Carcinoma: A Pilot Study. Mol Imaging Biol 2024; 26:264-271. [PMID: 38441862 DOI: 10.1007/s11307-024-01903-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE The current established technique for sentinel lymph node (SLN) biopsy is preoperative injection of 99mtechnetium-labeled nanosized colloids (99mTc) followed by single photon emission computed tomography and standard computed tomography (SPECT/CT) with subsequent intraoperative gamma probe-guided excision of the SLN. It is however time and resource consuming, causes radiation exposure and morbidity for the patient as the injection is done in the awake patient. Recently near-infrared imaging with indocyanine green (ICG) gained importance in SLN biopsy as a faster and more convenient technique. The objective of our study was to investigate the feasibility of SLN biopsy using ICG-imaging in early oral squamous cell carcinoma (OSCC). METHODS Single-centre pilot study of five patients with early-stage OSCC. For all patients, both techniques (99mTc and ICG) were performed. We injected 99mTc preoperatively in the awake patient, followed by SPECT/CT imaging. Intraoperatively ICG was injected around the primary tumor. Then the neck incision was performed according to the SPECT/CT images and SLN were detected by using a gamma probe and near-infrared fluorescence imaging of the ICG-marked lymph nodes intraoperatively. The excised lymph nodes were sent to histopathological examination according to the SLN dissection protocol. RESULTS In all five patients sentinel lymph nodes were identified. A total of 7 SLN were identified after injection of 99mTc, imaging with SPECT/CT and intraoperative use of a gamma probe. All these SLN were fluorescent and visible with the ICG technique. In two patients, we could identify additional lymph nodes using the ICG technique. Pathological analysis demonstrated occult metastasis in two of the cases. CONCLUSIONS Our study shows that ICG-guided SLN biopsy is a feasible technique, especially in combination with conventional radioisotope method and may help for intraoperative localization of SLN. Validation studies with bigger patient cohorts are needed to prove our results.
Collapse
Affiliation(s)
- Nadja A Stenz
- Department of Otorhinolaryngology - Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland.
| | - Gregoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Manuel Schoch
- Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Jonas Werner
- Department of Otorhinolaryngology - Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Gunesh P Rajan
- Department of Otorhinolaryngology - Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
- Otolaryngology, Head & Neck Surgery, Medical School, University of Western Australia, Perth, Australia
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| |
Collapse
|
4
|
Rich BJ, Samuels SE, Azzam GA, Kubicek G, Freedman L. Oral Cavity Squamous Cell Carcinoma: Review of Pathology, Diagnosis, and Management. Crit Rev Oncog 2024; 29:5-24. [PMID: 38683151 DOI: 10.1615/critrevoncog.2023050055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Squamous cell carcinoma of the oral cavity presents a significant global health burden, primarily due to risk factors such as tobacco smoking, smokeless tobacco use, heavy alcohol consumption, and betel quid chewing. Common clinical manifestations of oral cavity cancer include visible lesions and sores, often accompanied by pain in advanced stages. Diagnosis relies on a comprehensive assessment involving detailed history, physical examination, and biopsy. Ancillary imaging studies and functional evaluations aid in accurate staging and facilitate treatment planning. Prognostic information is obtained from histopathological factors, such as tumor grade, depth of invasion, lymphovascular invasion, and perineural invasion. Notably, lymph node metastasis, found in approximately half of the patients, carries significant prognostic implications. Effective management necessitates a multidisciplinary approach to optimize patient outcomes. Surgical resection is the backbone of treatment, aimed at complete tumor removal while preserving functional outcomes. Adjuvant therapies, including radiation and chemotherapy, are tailored according to pathological factors. Further work in risk stratification and treatment is necessary to optimize outcomes in squamous cell carcinoma of the oral cavity.
Collapse
Affiliation(s)
| | | | - Gregory A Azzam
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine
| | - Gregory Kubicek
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine
| | - Laura Freedman
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine
| |
Collapse
|
5
|
Akheel M, Wadhwania A, Venkataramu V, Vijay T, Qazi M, Suneja R. Regional Nodal Recurence as a Prognostic Factor in Patients Kept on Observation for cT1-T2 Oral Squamous Cell Carcinomas of Tongue: A Meta-Analysis of 11,973 Patients. Indian J Otolaryngol Head Neck Surg 2023; 75:3750-3756. [PMID: 37974831 PMCID: PMC10645994 DOI: 10.1007/s12070-023-04057-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/30/2023] [Indexed: 11/19/2023] Open
Abstract
The surgical management of the clinically node negative neck in T1-T2 early oral tongue squamous cell carcinoma (OTSCC) has been the topic of debate since few decades. As the occult cervical lymph node metastasis is considered to be the primary prognostic factor in early OTSCC, this meta-analysis has been carried out to find the risk of regional nodal recurrence on patients kept under observation than those who have underwent Elective neck dissection (END). The articles were electronically retrieved from Ovid Medline, PubMed, Cochrane and Scholar for comparison of Observation versus END in early OTSCC. The search strategy identified 35 relevant review articles from April 1979 to April 2020 from different search engines. A total of 11,973 patients from 30 retrospective analyses, 4 prospective and 1 randomized control trials were included in this meta-analysis. Overall test revealed (OR: 13.02 95% CI 1.360-17.154) with t test 2.382 and p value 0.023 which is statistically significant and showed that END significantly reduced the risk of regional nodal recurrence. This meta-analysis finds that there is statistically significant relationship when END was performed which reduced the risk of regional nodal recurrence as seen in patients kept on Observation thereby affecting the Overall survival (OS) rate.
Collapse
Affiliation(s)
- Mohammad Akheel
- College of Dentistry, City University Ajman, Ajman, UAE
- Adjunct Faculty, Department of Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Ashmi Wadhwania
- Modern Dental College and Hospital, Indore, Madhya Pradesh India
| | | | - Tanvi Vijay
- Pacific Dental College and Hospital, Udaipur, Rajasthan India
| | | | | |
Collapse
|
6
|
Guerlain J, Marhic A, Casiraghi O, Lumbroso J, Garcia G, Breuskin I, Janot F, Temam S, Gorphe P, Moya-Plana A. Occult nodal metastases in T1-T2cN0 oral squamous cell carcinoma: Correlation between sentinel node positivity and completion neck dissection analysis. Oral Oncol 2023; 139:106338. [PMID: 36807087 DOI: 10.1016/j.oraloncology.2023.106338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES Sentinel node procedure (SN) is a standard procedure that has shown its safety and effectiveness for T1/T2 cN0 oral squamous cell carcinoma (OSCC), with completion neck dissection (CND) for patients with positive SN. The aim of this study was to characterize the nodal involvement in a cohort of SN + OSCC. MATERIALS AND METHODS Patients with T1/T2 cN0 OSCC with positive SN with CND were included in this single-center, prospective cohort study between 2000 and 2013. RESULTS 54/301 patients had at least one positive SN. In 43/54 (80 %) cases, only the SN(s) were invaded; with only one SN involved (SN+=1) in 36/54 (67 %) cases. No predictive factors of nodal involvement in the CND were found considering the followings: SN micro/macrometastases, primary tumor's depth of invasion (DOI), perineural spread, lymphovascular involvement, primary tumor location, T stage and extranodal extension. The SN micrometastatic involvement (n = 22) was significantly associated with only one SN + CND- (p = 0.017). In the group of patients with unique micrometastatic involvement in the SN (n = 20/54), there was a higher isolated nodal recurrence free time (p = 0.017). CONCLUSION 80% of T1/T2 cN0 OSCC with positive SN had no other lymph node metastases in the CND, questioning the potential benefits of this procedure. Predictive factors such as the size of the SN metastasis need to be tested to stratify the risk of positive non-SN lymph nodes leading to a personalized treatment, lowering the therapeutic morbidity while maintaining the oncologic safety.
Collapse
Affiliation(s)
- J Guerlain
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France.
| | - A Marhic
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, Grand Paris, France
| | - J Lumbroso
- Nuclear Medicine Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - G Garcia
- Department of Medical Imaging, Gustave Roussy Cancer Campus, Grand Paris, France
| | - I Breuskin
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - F Janot
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - S Temam
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - P Gorphe
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - A Moya-Plana
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| |
Collapse
|
7
|
Akheel M, George RK, Tiwari S, Jain A, Chahwala Q, Wadhwania A. Elective Neck Dissection Versus Observation in cT1-T2 Oral Tongue Squamous Cell Carcinoma: A Meta-Analysis of 11,973 Patients. Indian J Otolaryngol Head Neck Surg 2022; 74:2256-2264. [PMID: 36452646 PMCID: PMC9701936 DOI: 10.1007/s12070-020-02118-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/27/2020] [Indexed: 12/24/2022] Open
Abstract
The surgical management of the clinical negative neck node in early oral tongue squamous cell carcinoma (OTSCC) has been the topic of debate since few decades. As the occult cervical lymph node metastasis is considered to be the prime prognostic factor in early OTSCC, this meta-analysis has been carried out to find the risk of regional nodal recurrence, disease specific survival and overall survival rates in outcome of Elective neck dissection (END) versus patients under observation. The articles were electronically retrieved from Ovid Medline, PubMed, Cochrane and Scholar for comparison of END versus Observation in early OTSCC. The search strategy identified 37 relevant review articles from April 1979 to April 2020 from different search engines. A total of 11,973 patients from 32 retrospective analysis, 4 prospective and 1 randomised control trial were included in this meta-analysis. Statistical analysis revealed Overall test (OR: 5.31 95% CI: - 2.132-14.698) with t-test 1.919 and p value 0.113 which is not statistically significant but the readings says that there is always better Disease specific survival with END patients rather than patients kept on observation. Overall test revealed (OR: 13.02 95% CI: 1.360-17.154) with t test 2.382 and p value 0.023 which is statistically significant and showed that End significantly reduced the risk of regional nodal recurrence. Overall test revealed (OR: 7.93 95% CI: - 15.461-4.238) with t test - 1.347 and p value 0.220 which is statistically insignificant and but showed that to some extent Overall survival improves in patient with END than the patients kept on observation. This meta-analysis find that there is statistically significant relationship when Elective neck dissection was performed which reduced the risk of regional nodal recurrence. This analysis didn't statistically find any significance in Disease specific survival and Overall survival with Elective neck dissection patients rather than patients kept on observation but however showed good prognosis when elective neck dissection was performed.
Collapse
Affiliation(s)
- Mohammad Akheel
- Oral & Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu India
| | - Rinku K. George
- Oral & Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu India
| | | | - Amit Jain
- Consultant radiation oncologist, SRJ-CBCC Cancer Centre, Indore, India
| | | | | |
Collapse
|
8
|
Suárez Ajuria M, Gallas Torreira M, García García A, Marichalar Mendía X, Chamorro Petronacci CM, Padín Iruegas E, Pérez Sayáns M. Efficacy of different sentinel lymph node biopsy protocols in oral squamous cell carcinoma: Systematic review and meta-analysis. Head Neck 2022; 44:1702-1714. [PMID: 35362176 PMCID: PMC9314893 DOI: 10.1002/hed.27042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/26/2022] [Accepted: 03/15/2022] [Indexed: 11/25/2022] Open
Abstract
The sentinel node biopsy (SNB) is highly protocolized in other cancers, however, this is not the case for oral squamous cell carcinoma patients, hence our objective was to evaluate the different protocols published. A specific study protocol was designed and subsequently registered on PROSPERO (Ref. CRD42021279217). Twenty‐three articles were included in the meta‐analysis. The grouped sensitivity of the SNB was 82% (95% CI: 0.74–0.88), and the grouped specificity was 100% (95% CI: 0.99–1.00). The use of other radiotracers other than pre‐operative lopamidol showed higher values of sensitivity of 82.80% (95% CI: 76.90%–87.50%; p < 0.001). The use of the blue dye stain showed higher sensitivity values of 85.60% (95% CI: 71.90%–93.20%), compared to sensitivity values of 77.50% when it was not used (95% CI: 69.10%–84.20%) (p < 0.001). Diagnostic rates are variable and they were significantly better when 99mTc was used in all its variations and accompanied by the blue dye staining.
Collapse
Affiliation(s)
- Maria Suárez Ajuria
- Oral Medicine and Surgery Unit, Faculty of dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Mercedes Gallas Torreira
- Oral Medicine and Surgery Unit, Faculty of dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Abel García García
- Oral Medicine and Surgery Unit, Faculty of dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | | | - Cintia M Chamorro Petronacci
- Oral Medicine and Surgery Unit, Faculty of dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Elena Padín Iruegas
- Faculty of Physiotherapy, Department of Functional Biology and Health Sciences, Human Anatomy and Embryology Area, Pontevedra, Spain
| | - Mario Pérez Sayáns
- Oral Medicine and Surgery Unit, Faculty of dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.,Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| |
Collapse
|
9
|
Yang G, Wei L, Thong BKS, Fu Y, Cheong IH, Kozlakidis Z, Li X, Wang H, Li X. A Systematic Review of Oral Biopsies, Sample Types, and Detection Techniques Applied in Relation to Oral Cancer Detection. BIOTECH 2022; 11:5. [PMID: 35822813 PMCID: PMC9245907 DOI: 10.3390/biotech11010005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 12/11/2022] Open
Abstract
Background: Early identification of the stage of oral cancer development can lead to better treatment outcomes and avoid malignant transformation. Therefore, this review aims to provide a comprehensive overview that describes the development of standardized procedures for oral sample collection, characterization, and molecular risk assessment. This can help investigators to choose the appropriate sampling method and downstream analyses for different purposes. Methods: This systematic review was conducted according to the PRISMA guidelines. Using both PubMed and Web of Science databases, four independent authors conducted a literature search between 15 and 21 June 2021. We used key search terms to broaden the search for studies. Non-conforming articles were removed using an EndNote-based and manual approach. Reviewers used a designed form to extract data. Results: This review included a total of 3574 records, after eliminating duplicate articles and excluding papers that did not meet the inclusion criteria. Finally, 202 articles were included in this review. We summarized the sampling methods, biopsy samples, and downstream analysis. The biopsy techniques were classified into tissue and liquid biopsy. The common sequential analysis of tissue biopsy includes histopathological examination such as H&E or IHC to identify various pathogenic features. Meanwhile, liquid samples such as saliva, blood, and urine are analyzed for the purpose of screening to detect mutations in cancer. Commonly used technologies are PCR, RT-PCR, high-throughput sequencing, and metabolomic analysis. Conclusions: Currently, tissue biopsies provide increased diagnostic value compared to liquid biopsy. However, the minimal invasiveness and convenience of liquid biopsy make it a suitable method for mass screening and eventual clinical adoption. The analysis of samples includes histological and molecular analysis. Metabolite analysis is rising but remains scarce.
Collapse
Affiliation(s)
- Guanghuan Yang
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Luqi Wei
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Benjamin K. S. Thong
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Yuanyuan Fu
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Io Hong Cheong
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, 69372 Lyon, France;
| | - Xue Li
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Hui Wang
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| | - Xiaoguang Li
- State Key Laboratory of Oncogenes and Related Genes, Centre for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (G.Y.); (L.W.); (B.K.S.T.); (Y.F.); (I.H.C.); (X.L.)
| |
Collapse
|
10
|
Elshamaa MM, Mahran H, Dayashankara Rao JK, Elborolosy SA. A retrospective analysis of 5-year post surgery recurrence of N0 neck and the role of methylene blue in sentinel lymph node biopsy. J Oral Biol Craniofac Res 2021; 12:49-54. [PMID: 34754724 DOI: 10.1016/j.jobcr.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/26/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study is to perform a retrospective analysis of the feasibility of the clinical application of SLNB using methylene blue dye (MBD) for the identification of SLN followed by frozen section biopsy to detect occult metastasis in clinically N0 necks. Hence, to know the reliability of MBD in reducing the need for extensive surgery. Methods We retrospectively analyzed the clinic pathological data of 48 patients with early oral cancer.The SLN identification rate (IR) was calculated in SLNB with MBD and the false-negative rate (FNR). Intra operative frozen section biopsy was done for all patients was compared with post-operative paraffin histopathology report and the prognosis of patients was analyzed. Results Analysis of the 48 SLNB cases showed that there were significant differences in SLN successful detection rate among patients with different site (p = 0.043) and clinical presentation (p = 0.007). Similar significant results (p < 0.05) were observed with intra-operative frozen and post-operative paraffin histopathology sections. SLNs were successfully detected in 37(77.1%) patients out of 48. The intra operative frozen histopathology completely matched with the post-operative paraffin histopathology showing 39 (81.2%) negative and 09 (18.8%) positive cases. A prognostic analysis of SLN detection based on 48 patients showed that the 5-year survival rate was 100%. Conclusion MBD has acceptable SLN identification rate and a low FNR(false negative report) in frozen sections. Stained SLNs with no SLN metastasis are associated with disease-free survival (DFS). Hence, MBD-SLN biopsy has significantly reduced the need for extensive neck dissection in N0 neck with less morbidity.
Collapse
Affiliation(s)
| | - Hamada Mahran
- General Surgery Department Faculty of Medicine, Assiut University, Egypt
| | | | - Samir Ali Elborolosy
- Oral and Maxillofacial Surgery Department Faculty of Dentistry, Beni-Suef University, Egypt
| |
Collapse
|
11
|
Analysis of the Efficiency and Prognostic Value of the Sentinel Node Technique in Oral Squamous Cell Carcinoma after Seven Years. ACTA ACUST UNITED AC 2021; 57:medicina57101092. [PMID: 34684129 PMCID: PMC8540189 DOI: 10.3390/medicina57101092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/07/2021] [Accepted: 10/10/2021] [Indexed: 11/16/2022]
Abstract
Background and objectives: The purpose of this study was to analyse the diagnostic and prognostic efficiency of the sentinel lymph node biopsy technique (SLNB). Materials and Methods: This is a prospective observational study performed by the Hospital Complex in Santiago de Compostela (CHUS) in Spain, between February 2013 and June 2020. The study included 60 patients, who had been diagnosed with OSCC in stage T1/T2N0M0. Results: 10 patients (16.7%) presented with SN+ (sentinel node positive). The majority (80%) only presented subcapsular affection, however one case also presented with extracapsular affection. Using the Kaplan–Meier curves, we determined that the average survival estimation for SN− patients was 74.0 months (CI95% 67.6–80.5) and it was 45.4 months (CI95% 10.9–24.0) for SN+ patients (p = 0.002). SN+ patients presented an OR = 11.000 (CI95% 2.393–50.589, p = 0.002) for cancer-related mortality. In terms of the diagnostic performance of the SN (sentinel node) test, a 55% sensitivity, a 100% specificity, 100% PPV and a 84% NPV were obtained. The analysis using ROC (receiver operating characteristic) curves revealed an AUC = 0.671 (CI95% 0.492–0.850, p = 0.046). Conclusions: SLNB seems to be an adequate technique for the detection of hidden metastases.
Collapse
|
12
|
King C, Elsherif N, Kirwan R, Schilling C, Hall G, Morgan P, Collins L, Sandison A, Odell E, Thavaraj S. Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma. Head Neck 2021; 43:2985-2993. [PMID: 34128276 DOI: 10.1002/hed.26784] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/21/2021] [Accepted: 06/07/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Sentinel lymph node (SLN) biopsy is an accurate staging modality in early oral squamous cell carcinoma (OSCC), but its accuracy relies on labor-intensive histopathology protocols. We sought to determine whether serial step sections with immunohistochemistry (SSSIHC) at narrow intervals of the entire SLN are required to accurately exclude metastasis. METHODS Consecutive SLN biopsies over a 13-year period were retrospectively evaluated. If the index section was negative for carcinoma, the entire SLN was subjected to SSSIHC at 150 μm intervals. The first section level and total number of section levels to contain carcinoma were recorded. RESULTS One hundred and eighteen SLN+ from 90 patients were included. SSSIHC upstaged the nodal status in 19.5% of patients. Metastasis was identified in 16.7% and 10.2% beyond section levels 4 and 6, respectively. Among SLNs requiring SSSIHC, 47.5% contained carcinoma in a single section level. CONCLUSION SSSIHC of the entire SLN at 150 μm intervals are required to identify occult metastasis in OSCC.
Collapse
Affiliation(s)
- Claire King
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Nusaybah Elsherif
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ruaidhrí Kirwan
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Clare Schilling
- Head & Neck Surgery, University College London Hospital, London, UK.,Head and Neck Academic Centre, University College London, London, UK
| | - Gillian Hall
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Peter Morgan
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Faculty of Oral, Dental and Craniofacial Science, King's College London, London, UK
| | - Lisette Collins
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ann Sandison
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Edward Odell
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Faculty of Oral, Dental and Craniofacial Science, King's College London, London, UK
| | - Selvam Thavaraj
- Head & Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Faculty of Oral, Dental and Craniofacial Science, King's College London, London, UK
| |
Collapse
|
13
|
de Kerangal Q, Kapso R, Morinière S, Laure B, Bonastre J, Moya-Plana A. Sentinel lymph node biopsy versus selective neck dissection in patients with early oral squamous cell carcinoma: A cost analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:372-376. [PMID: 34000437 DOI: 10.1016/j.jormas.2021.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sentinel lymph node biopsy (SLNB) has been proved to be as efficient as selective neck dissection (SND) for the treatment of occult metastases in T1-T2cN0 oral squamous cell carcinoma (OSCC). The aim of our study was to assess and compare the cost of these two surgical procedures. PATIENTS AND METHODS This retrospective cost analysis includes consecutive patients treated between 2012 and 2017 in two French hospitals either by SLNB or SND. Hospital cost (hospital stay for initial surgery and re-hospitalizations over a period of 60 days after the initial surgery), the length of hospital stay for the initial surgery and the perioperative management were described and compared between the two techniques. The propensity score regression adjustment method was used to address selection bias. RESULTS Ninety-four patients underwent SLNB procedure and seventy-seven patients underwent SND. The length of hospital stay for initial surgery was lower in SLNB group: 5.8 days (SD: 3.8) versus 9.2 days (SD: 5) in the SND group. Hospital costs were lower in SLNB group: €7 489 (standard deviation: €3 691) versus €8 886 (standard deviation: €4 381) but this difference was not significant after propensity score regression adjustment. The rate of complication, the delay of full oral feeding and postoperative drainage were lower in SLNB group. CONCLUSION SLNB in T1-T2cN0 OSCC is less invasive than SND with fewer complications, a shorter length of hospital stay and favorable perioperative management. This study shows that this technique could be also less expensive than SND.
Collapse
Affiliation(s)
- Quitterie de Kerangal
- Head and Neck Oncology Department, Gustave Roussy, Paris-Saclay University, F-94805, Villejuif, France.
| | - Raissa Kapso
- Biostatistics and Epidemiology Department, Gustave Roussy, Paris-Saclay University, F-94805, Villejuif, France
| | - Sylvain Morinière
- Head and Neck Surgery Department, Tours University Hospital, F-37044 Tours Cedex 9 France
| | - Boris Laure
- Maxillo-facial and Plastic Surgery Department, Tours University Hospital, F-37044 Tours Cedex 9, France
| | - Julia Bonastre
- Biostatistics and Epidemiology Department, Gustave Roussy, Paris-Saclay University, F-94805, Villejuif, France; UVSQ, CESP, INSERM, Paris-Saclay University, Paris-Sud University, F-94805, Villejuif, France
| | - Antoine Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy, Paris-Saclay University, F-94805, Villejuif, France
| |
Collapse
|
14
|
Nuyts S, Bollen H, Eisbruch A, Corry J, Strojan P, Mäkitie AA, Langendijk JA, Mendenhall WM, Smee R, DeBree R, Lee AWM, Rinaldo A, Ferlito A. Unilateral versus bilateral nodal irradiation: Current evidence in the treatment of squamous cell carcinoma of the head and neck. Head Neck 2021; 43:2807-2821. [PMID: 33871090 DOI: 10.1002/hed.26713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 12/21/2022] Open
Abstract
Cancers of the head and neck region often present with nodal involvement. There is a long-standing convention within the community of head and neck radiation oncology to irradiate both sides of the neck electively in almost all cases to include both macroscopic and microscopic disease extension (so called elective nodal volume). International guidelines for the selection and delineation of the elective lymph nodes were published in the early 2000s and were updated recently. However, diagnostic imaging techniques have improved the accuracy and reliability of nodal staging and as a result, small metastases that used to remain undetected and were thus in the past included in the elective nodal volume, will now be included in high-dose volumes. Furthermore, the elective nodal areas are situated close to the parotid glands, the submandibular glands and the swallowing muscles. Therefore, irradiation of a smaller, more selected volume of the elective nodes could reduce treatment-related toxicity. Several researchers consider the current bilateral elective neck irradiation strategies an overtreatment and show growing interest in a unilateral nodal irradiation in selected patients. The aim of this article is to give an overview of the current evidence about the indications and benefits of unilateral nodal irradiation and the use of SPECT/CT-guided nodal irradiation in squamous cell carcinomas of the head and neck.
Collapse
Affiliation(s)
- Sandra Nuyts
- Laboratory of Experimental Radiotherapy, Department of Oncology, Leuven, Belgium
- Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Heleen Bollen
- Laboratory of Experimental Radiotherapy, Department of Oncology, Leuven, Belgium
- Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Avrahram Eisbruch
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - June Corry
- Division of Medicine, Department of Radiation Oncology, St. Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Primoz Strojan
- Department of Radiation Oncology, Institute of Oncology, University of Ljubljana, Ljubljana, Slovenia
| | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, HUS Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Johannes A Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, the Netherlands
| | - William M Mendenhall
- Department of Radiation Oncology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Robert Smee
- Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, New South Wales, Australia
| | - Remco DeBree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Anne W M Lee
- Department of Clinical Oncology, University of Hong Kong, Hong Kong, China
| | - Alessandra Rinaldo
- Department of Otolaryngology, University of Udine School of Medicine, Udine, Italy
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Udine, Italy
| |
Collapse
|
15
|
Diagnostic yield of sentinel lymph node biopsy in oral squamous cell carcinoma T1/T2-N0: systematic review and meta-analysis. Int J Oral Maxillofac Surg 2021; 50:1271-1279. [PMID: 33602650 DOI: 10.1016/j.ijom.2021.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 12/24/2022]
Abstract
The objective of this study was to conduct a systematic review and meta-analysis on the efficacy of sentinel lymph node biopsy (SLNB) in T1/T2-N0 oral squamous cell carcinoma (OSCC). A systematic review of the literature on SLNB until March 2019 was conducted. The review was organized according to the PRISMA protocol, considering the following PICO (population, intervention, comparison, outcome) question: What is the sensitivity of sentinel lymph node biopsy in OSCC? 'P' was patients with head and neck squamous cell carcinoma T1/2-N0; 'I' was SLNB; 'C' was neck treated with elective neck dissection and haematoxylin-eosin histopathology; 'O' was sensitivity and specificity. A meta-analysis and meta-regression were performed on the selected studies. The sensitivity of SLNB was up to 88% (95% confidence interval (CI) 72-96%) and specificity was up to 99% (95% CI 96-100%). The area under the summary receiver operating characteristic curve was 0.99 (95% CI 0.98-1.00). In the four studies where immunohistochemistry was performed, both the sensitivity and specificity were higher than in the studies without immunohistochemistry: 93% (95% CI 88-97%) and 98% (95% CI 96-100%), respectively. In conclusion, SLNB is an effective technique for treating patients with some types of stage T1/2-N0 OSCC. Some parameters such as immunohistochemistry could determine the level of diagnostic accuracy.
Collapse
|
16
|
Skanjeti A, Dhomps A, Paschetta C, Tordo J, Delgado Bolton RC, Giammarile F. Lymphoscintigraphy for Sentinel Node Mapping in Head and Neck Cancer. Semin Nucl Med 2020; 51:39-49. [PMID: 33246538 DOI: 10.1053/j.semnuclmed.2020.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of this comprehensive review is to describe and analyze the role of the sentinel node mapping in head and neck cancers. For this purpose, head and neck neoplasms have been categorized in cutaneous malignancies and neoplasms of the upper aerodigestive tract. A concise description of lymphatic drainage will be the "prelude" for each section, as well as the description of the injection techniques, when specific. Concisely, the attention has been focused on detection rate of the sentinel node by lymphoscintigraphy for each cancer, and for those patients in which the sentinel lymph node has been identified, true-positives rates, false-negative rates, and overall accuracy has been pointed out. Overall, in cutaneous neoplasms of the head and neck, the detection rate is higher than 90%, however the false-negative rate is still an issue, in particular in melanoma, inducing the need for newer developments. In fact, new tracers and techniques are already available, while prospective multicenter trials exploring the outcome impact are needed in the near future. For the upper aerodigestive tract and in particular oral cavity and oropharynx, sentinel lymph node identification by lymphoscintigraphy allows avoiding unnecessary neck dissection and/or node irradiation. Even in this case, the main limit remains the risk of false-negative rates. While, for patients affected by laryngeal and hypopharyngeal cancers the data seem very limited and, although the feasibility has been demonstrated, performances of this lymphoscintigraphy still need to be confirmed by multicenter studies.
Collapse
Affiliation(s)
- Andrea Skanjeti
- Nuclear Medicine Department, Hospices Civils de Lyon and Université Claude Bernard Lyon 1, Lyon, France
| | - Anthony Dhomps
- Nuclear Medicine Department, Hospices Civils de Lyon, Lyon, France
| | | | - Jérémie Tordo
- Nuclear Medicine Department, Hospices Civils de Lyon, Lyon, France
| | - Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency (IAEA), Vienna, Austria; Centre Léon Bérard, Lyon, France.
| |
Collapse
|
17
|
Kim DH, Kim Y, Kim SW, Hwang SH. Usefulness of Sentinel Lymph Node Biopsy for Oral Cancer: A Systematic Review and Meta-Analysis. Laryngoscope 2020; 131:E459-E465. [PMID: 32401367 DOI: 10.1002/lary.28728] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We assessed the diagnostic accuracy of sentinel lymph node biopsy (SLNB) for detecting neck nodal metastasis in early oral squamous cell carcinoma (OSCC) as an alternative to elective neck dissection. STUDY DESIGN A systematic search for relevant literature was conducted in the PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases. METHODS Two reviewers individually searched the five databases up to November 2019. For studies that met inclusion criteria, data on patient diagnoses were pooled, including true positives, true negatives, false positives, and false negatives. Methodological quality was checked with the Quality Assessment of Diagnostic Accuracy Studies (version 2) tool. RESULTS In total, 98 observational or retrospective studies were included. The diagnostic odds ratio of SLNB was 326.165 (95% confidence interval [CI]: 231.477-459.587; I2 = 0%). The area under the summary receiver operating characteristic curve was 0.982. Sensitivity was 0.827 (95% CI: 0.804-0.848), and specificity was 0.981 (95% CI: 0.975-0.986). The correlation between sensitivity and the false positive rate was -0.076, which indicates that heterogeneity did not exist. Subgroup analyses were performed with the subgroups reference test type, publication year, and study type. No significant difference was found within the reference test type subgroup. However, differences within the publication year and study type subgroups were significant, where the retrospective study subgroup was significantly more sensitive and specific than the prospective study subgroup. CONCLUSION Results of this meta-analysis imply that the high specificity of SLNB supports its role as a diagnostic tool for patients with clinical tumor stage (CT)1-2 clinically negative (N0) OSCC. More studies should be done to further verify the results of this study. LEVEL OF EVIDENCE 2a Laryngoscope, 131:E459-E465, 2021.
Collapse
Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yeonji Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| |
Collapse
|
18
|
Moya-Plana A, Guerlain J, Casiraghi O, Bidault F, Grimaldi S, Breuskin I, Gorphe P, Temam S. [Sentinel lymph node biopsy in head and neck oncology]. Bull Cancer 2019; 107:653-659. [PMID: 31610909 DOI: 10.1016/j.bulcan.2019.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/23/2019] [Indexed: 02/06/2023]
Abstract
Sentinel lymph node biopsy (SLNB) has been initially developed for melanoma and breast cancers. Its application in head and neck cancers is recent, probably due to the complexity of the lymphatic drainage, the proximity between the primary tumor and the lymph nodes and the critical anatomical structures (such as the facial nerve). In onco-dermatology, SLNB is validated in head and neck surgery for melanoma with Breslow thickness up to 1mm or ulceration, Merkel carcinoma and high-risk squamous cell carcinoma. Considering the malignancies of the upper aerodigestive tract, the feasibility and oncologic safety of SLNB are now established for T1-T2N0 oral and oropharyngeal squamous cell carcinomas. Thus, it could allow patients with negative sentinel nodes to avoid an unnecessary neck dissection, leading to a decrease of morbidity with an quality of life improvement. For some primary locations (e.g., anterior floor of the mouth) with high proximity between tumor and lymph nodes, it is recommended to remove the tumor before the SLNB so as to improve the detection. New techniques of detection are currently being developed with intra-operative procedures and new tracers (such as tilmanocept), leading to a better accuracy of detection and, probably, new indications.
Collapse
Affiliation(s)
- Antoine Moya-Plana
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France.
| | - Joanne Guerlain
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Odile Casiraghi
- Université Paris-Saclay, département d'anatomopathologie, Gustave Roussy, 94805 Villejuif, France
| | - François Bidault
- Université Paris-Saclay, département de radiologie, Gustave Roussy, 94805 Villejuif, France
| | - Séréna Grimaldi
- Université Paris-Saclay, département de médecine nucléaire, Gustave Roussy, 94805 Villejuif, France
| | - Ingrid Breuskin
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Philippe Gorphe
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Stéphane Temam
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| |
Collapse
|
19
|
Vishnoi J, Kumar V, Gupta S, Chaturvedi A, Misra S, Akhtar N, Agarwal P, Jamal N, Pareek P. Outcome of sentinel lymph node biopsy in early-stage squamous cell carcinoma of the oral cavity with methylene blue dye alone: a prospective validation study. Br J Oral Maxillofac Surg 2019; 57:755-759. [DOI: 10.1016/j.bjoms.2019.06.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 06/27/2019] [Indexed: 02/05/2023]
|
20
|
Garau LM, Muccioli S, Caponi L, Maccauro M, Manca G. Sentinel lymph node biopsy in oral–oropharyngeal squamous cell carcinoma: standards, new technical procedures, and clinical advances. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00338-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
21
|
Topographical distribution of sentinel nodes and metastases from T1-T2 oral squamous cell carcinomas. Eur J Cancer 2018; 107:86-92. [PMID: 30553161 DOI: 10.1016/j.ejca.2018.10.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 10/08/2018] [Accepted: 10/23/2018] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The objective is to investigate the topographical distribution of sentinel nodes (SNs) and lymph node metastases in T1-2cN0 oral squamous cell carcinomas (OSCCs). METHODS The study entailed a prospective enrolment of 220 patients with clinical T1-2N0 OSCCs who underwent preoperative lymphoscintigraphy (LSG) followed by gamma probe-guided sentinel lymph node biopsy (SLNB). Patients with positive SNs were treated with completion neck dissection. Excised lymph nodes were grouped into the neck level according to the international guidelines. RESULTS The SN detection rate by LSG was 99.1%. Patients with midline tumours had bilateral lymphatic drainage on LSG in 15/21 (71.5%). There were 45/199 (22.6%) patients with lateralised tumours that had unexpected bilateral or contralateral drainage patterns on LSG. Fifty-five patients (25.0%) were SLNB positive, and metastases were found in 72/781 (9.2%) of the excised SNs. Metastatic involvement of neck level IV was rare and only observed in patients with anterior tongue cancer. No patients had level V involvement. Eleven patients developed isolated cervical recurrences, with no new primary tumour as origin. The SLNB procedure ensured an overall sensitivity of 83.3% and a negative predictive value of 93.3%. CONCLUSION Completion neck dissection of level I-III in SLNB-positive patients might be sufficient in most patients with OSCC except patients with anterior tongue cancer, but further studies are needed to support this potential therapeutic algorithm. Our study showed that SLNB was helpful in clarifying unexpected bilateral or contralateral metastatic drainage patterns. In our cohort, 8/55 patients with occult metastasis would have been missed by elective neck dissection of the ipsilateral neck.
Collapse
|
22
|
Hingsammer L, Seier T, Zweifel D, Huber G, Rücker M, Bredell M, Lanzer M. Sentinel lymph node biopsy for early stage tongue cancer-a 14-year single-centre experience. Int J Oral Maxillofac Surg 2018; 48:437-442. [PMID: 30389112 DOI: 10.1016/j.ijom.2018.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 02/05/2023]
Abstract
This study was performed to report the usage of sentinel lymph node biopsy (SLNB) in clinical stage I or II tongue cancer patients with cN0 necks seen over a 14-year period. Data were collected prospectively, and a retrospective analysis was performed of 41 patients with early stage oral squamous cell carcinoma of the tongue and a cN0 neck. Sentinel lymph node (SLN)-positive patients underwent elective neck dissection, whereas SLN-negative patients were kept under careful observation. Seven of the 41 (17%) patients enrolled in the study were found to have occult metastases. The patients were followed up for a mean duration of 92 months (range 60-144 months). The neck recurrence rate for SLN-positive patients was 0% and for SLN-negative patients was 3%. The authors recommend the routine use of SLNB in patients with early stage oral squamous cell carcinoma of the tongue and a cN0 neck. Furthermore, special focus should be placed on isolated tumour cells, as their presence is of high clinical relevance.
Collapse
Affiliation(s)
- L Hingsammer
- Department of Oral and Maxillofacial Surgery, University Clinic of Zurich, Zurich, Switzerland.
| | - T Seier
- Department of Oral and Maxillofacial Surgery, University Clinic of Zurich, Zurich, Switzerland
| | - D Zweifel
- Department of Oral and Maxillofacial Surgery, University Clinic of Zurich, Zurich, Switzerland
| | - G Huber
- Department of Ear, Nose and Throat, University Clinic of Zurich, Zurich, Switzerland
| | - M Rücker
- Department of Oral and Maxillofacial Surgery, University Clinic of Zurich, Zurich, Switzerland
| | - M Bredell
- Department of Oral and Maxillofacial Surgery, University Clinic of Zurich, Zurich, Switzerland
| | - M Lanzer
- Department of Oral and Maxillofacial Surgery, University Clinic of Zurich, Zurich, Switzerland
| |
Collapse
|
23
|
Small oral tongue cancers (≤ 4 cm in diameter) with clinically negative neck: from the 7th to the 8th edition of the American Joint Committee on Cancer. Virchows Arch 2018; 473:481-487. [PMID: 30039390 DOI: 10.1007/s00428-018-2417-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 07/15/2018] [Indexed: 01/20/2023]
Abstract
One of the main changes in the 8th edition of the American Joint Committee on Cancer (AJCC) for staging of oral cancer is the inclusion of depth of invasion (DOI) in the T category. However, cancers in different oral subsites have variable behavior, with oral tongue squamous cell carcinoma (OTSCC) being the most aggressive one even at early stage. Thus, it is necessary to evaluate the performance of this new T category in homogenous cohort of early OTSCC. Therefore, we analyzed a large cohort of patients with a small (≤ 4 cm) OTSCC to demonstrate the differences in T stage between the AJCC 7th and 8th editions. A total of 311 early-stage cases (AJCC 7th) of OTSCC were analyzed. We used 5 mm and 10 mm DOI for upstaging from T1 to T2 and from T2 to T3 respectively, as in the AJCC 8th. We further reclassified the cases according to our own proposal suggesting 2 mm to upstage to T2 and 4 mm to upstage to T3. According to AJCC 7th, there were no significant differences in the survival analysis. When we applied the 8th edition, many cases were upstaged to T3 and thus associated with worse disease-specific survival (HR 2.37, 95% CI 1.12-4.99) and disease-free survival (HR 2.12, 95% CI 1.09-4.08). Based on our proposal, T3 cases were associated with even worse disease-specific survival (HR 4.19, 95% CI 2.27-7.74). The 8th edition provides better survival prediction for OTSCC than the 7th and can be further optimized by lowering the DOI cutoffs.
Collapse
|
24
|
Moya-Plana A, Aupérin A, Guerlain J, Gorphe P, Casiraghi O, Mamelle G, Melkane A, Lumbroso J, Janot F, Temam S. Sentinel node biopsy in early oral squamous cell carcinomas: Long-term follow-up and nodal failure analysis. Oral Oncol 2018; 82:187-194. [DOI: 10.1016/j.oraloncology.2018.05.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/20/2018] [Accepted: 05/25/2018] [Indexed: 02/06/2023]
|
25
|
Duan Q, Xu M, Zhang X, Jia M, Yuan R, Gan M. Clinical significance of cytokeratin in the cervical lymph nodes of patients with mandibular gingival squamous cell carcinoma. Oncol Lett 2018; 16:3135-3139. [PMID: 30127905 PMCID: PMC6096087 DOI: 10.3892/ol.2018.9005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 06/12/2018] [Indexed: 12/13/2022] Open
Abstract
The present study aims to analyze the expression of broad spectrum cytokeratin in the cervical lymph nodes of patients with mandibular gingival squamous cell carcinoma and explore the metastasis of mandibular gingival squamous cell carcinoma in cervical lymph nodes. This study included 42 patients with mandibular gingival squamous cell carcinoma, which was staged according to the clinical staging criteria by International Union Against Cancer 2002 (UICC) and the Level staging method of cervical lymph node by American Academy of Otolaryngology-Head and Neck Surgery 1991. Monoclonal mouse anti-human cytokeratin (AE1/AE3) antibody was used in immunohistochemical examination and hematoxylin and eosin (H&E) staining. All positive sections by H&E staining were also positive by immunohistochemistry (IHC). The positive rate of routine H&E staining and serial-section H&E staining was 8.03 and 9.57%, respectively, the positive rate of IHC was 12.82%. The positive rate of IHC was significantly different with that of routine H&E staining (χ2=7.17, P<0.01), yet not significantly different with that of serial-section H&E staining (χ2=3.10, P>0.05). Lymph node metastasis was mainly in Level I, II and III, both serial-section H&E staining and IHC showed lymph node metastasis in Level IV for advanced patients. IHC showed 19 lymph node micrometastasis in 12 patients, while neither serial-section nor routine H&E staining showed micrometastasis. Lymph node dissection of hyoid bone (mainly in Level I, II and III) could be used for early patients, and the dissection could be expanded to Level IV for advanced patients.
Collapse
Affiliation(s)
- Qingyun Duan
- Oral and Maxillofacial Surgery, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang 310006, P.R. China
| | - Mei Xu
- Department of Ophtalmology, Hangzhou Jianggan District People's Hospital, Hangzhou, Zhejiang 310016, P.R. China
| | - Xiong Zhang
- Oral and Maxillofacial Surgery, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang 310006, P.R. China
| | - Muyun Jia
- Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University Medical College, Qingdao, Shandong 266003, P.R. China
| | - Rongtao Yuan
- Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University Medical College, Qingdao, Shandong 266003, P.R. China
| | - Min Gan
- Oral and Maxillofacial Surgery, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, Zhejiang 310006, P.R. China
| |
Collapse
|
26
|
Boeve K, Schepman K, Schuuring E, Roodenburg J, Halmos G, Dijk B, Boorsma R, Visscher J, Brouwers A, Vegt B, Witjes M. 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; 43:1080-1087. [DOI: 10.1111/coa.13107] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2018] [Indexed: 02/05/2023]
Affiliation(s)
- K. Boeve
- Department of Oral and Maxillofacial Surgery University of Groningen University Medical Center Groningen Groningen The Netherlands
- Department of Pathology & Medical Biology University of Groningen University Medical Center Groningen Groningen The Netherlands
| | - K.P. Schepman
- Department of Oral and Maxillofacial Surgery University of Groningen University Medical Center Groningen Groningen The Netherlands
| | - E. Schuuring
- Department of Pathology & Medical Biology University of Groningen University Medical Center Groningen Groningen The Netherlands
| | - J.L.N. Roodenburg
- Department of Oral and Maxillofacial Surgery University of Groningen University Medical Center Groningen Groningen The Netherlands
| | - G.B. Halmos
- Department of Otorhinolaryngology/Head & Neck Surgery University of Groningen University Medical Center Groningen Groningen The Netherlands
| | - B.A.C. Dijk
- Department of Epidemiology University of Groningen University Medical Center Groningen Groningen The Netherlands
- Department of Research Comprehensive Cancer Organization The Netherlands (IKNL) Utrecht The Netherlands
| | | | - J.G.A.M. Visscher
- Department of Oral and Maxillofacial Surgery Medical Center Leeuwarden Leeuwarden The Netherlands
| | - A.H. Brouwers
- Department of Nuclear Medicine & Molecular Imaging University of Groningen University Medical Center Groningen Groningen The Netherlands
| | - B. Vegt
- Department of Pathology & Medical Biology University of Groningen University Medical Center Groningen Groningen The Netherlands
| | - M.J.H. Witjes
- Department of Oral and Maxillofacial Surgery University of Groningen University Medical Center Groningen Groningen The Netherlands
| |
Collapse
|
27
|
Foy JP, Kolb F, Routier E, Cavalcanti A, Lumbroso J, Tomasic G, Mateus C, Temam S, Robert C, Moya-Plana A. Sentinel lymph node biopsy in 33 non-melanoma skin cancers of the head and neck: A twelve-year experience with long-term follow-up. Clin Otolaryngol 2018; 43:1148-1152. [PMID: 29575799 DOI: 10.1111/coa.13100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/26/2022]
Affiliation(s)
- J P Foy
- Department of Head & Neck Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - F Kolb
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - E Routier
- Department of Onco-Dermatology, Gustave Roussy Cancer Campus, Villejuif, France
| | - A Cavalcanti
- Department of Oncologic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - J Lumbroso
- Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - G Tomasic
- Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - C Mateus
- Department of Onco-Dermatology, Gustave Roussy Cancer Campus, Villejuif, France
| | - S Temam
- Department of Head & Neck Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - C Robert
- Department of Onco-Dermatology, Gustave Roussy Cancer Campus, Villejuif, France.,Faculté de Médecine du Kremlin-Bicêtre, Université Paris Sud, Université Paris Saclay, Le Kremlin-Bicêtre, France
| | - A Moya-Plana
- Department of Head & Neck Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
28
|
Median Lingual Lymph Nodes: Prevalence on Imaging and Potential Implications for Oral Cavity Cancer Staging. J Comput Assist Tomogr 2017; 41:528-534. [PMID: 28099223 DOI: 10.1097/rct.0000000000000568] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study sought to estimate the prevalence of median lingual lymph node (MLLN) metastases from oral cavity squamous cell carcinoma (OCSCC) and determine the frequency with which MLLNs can be identified with magnetic resonance imaging (MRI) in control subjects. METHODS Pathology reports were used to identify patients with surgically treated OCSCC who underwent preoperative positron emission tomography-computed tomography to define the prevalence of MLLN metastases. As a control group, 500 consecutive face-neck MRIs from noncancer patients were reviewed for structures consistent with MLLNs. RESULTS In the study group, 1 (0.95%) of 105 OCSCC cases demonstrated a single MLLN metastasis from a lateral tongue tumor (T4aN2c). The MLLN exceeded 1 cm in all planes and was abnormal in morphology. The frequency of suspected MLLNs in controls was 1.0%, with a maximum measurement of 0.9 cm. CONCLUSIONS Median lingual lymph nodes are infrequently identified with MRI in controls, concordant with the low prevalence of metastases from OCSCC to this inconstant nodal group.
Collapse
|
29
|
Sharma D, Koshy G, Grover S, Sharma B. Sentinel Lymph Node Biopsy: A new approach in the management of head and neck cancers. Sultan Qaboos Univ Med J 2017; 17:e3-e10. [PMID: 28417021 PMCID: PMC5380418 DOI: 10.18295/squmj.2016.17.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/21/2016] [Accepted: 10/06/2016] [Indexed: 12/14/2022] Open
Abstract
Cervical lymph node metastasis affects the prognosis and overall survival rate of and therapeutic planning for patients with head and neck squamous cell carcinomas (HNSCCs). However, advanced diagnostic modalities still lack accuracy in detecting occult neck metastasis. A sentinel lymph node biopsy is a minimally invasive auxiliary method for assessing the presence of occult metastatic disease in a patient with a clinically negative neck. This technique increases the specificity of neck dissection and thus reduces morbidity among oral cancer patients. The removal of sentinel nodes and dissection of the levels between the primary tumour and the sentinel node or the irradiation of target nodal basins is favoured as a selective treatment approach; this technique has the potential to become the new standard of care for patients with HNSCCs. This article presents an update on clinical applications and novel developments in this field.
Collapse
Affiliation(s)
- Deepti Sharma
- Department of Oral & Maxillofacial Pathology, Christian Dental College & Hospital, Ludhiana, Punjab, India
| | - George Koshy
- Department of Oral & Maxillofacial Pathology, Christian Dental College & Hospital, Ludhiana, Punjab, India
| | - Sonal Grover
- Department of Oral & Maxillofacial Pathology, Christian Dental College & Hospital, Ludhiana, Punjab, India
| | - Bhushan Sharma
- Department of Oral & Maxillofacial Pathology, Christian Dental College & Hospital, Ludhiana, Punjab, India
| |
Collapse
|
30
|
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. [PMID: 28107500 PMCID: PMC5249063 DOI: 10.1371/journal.pone.0170322] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 01/03/2017] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The diagnostic efficacy of sentinel lymph node biopsy(SLNB) in early oral squamous cell carcinoma(OSCC) still remains controversial. This meta-analysis was conducted to assess the diagnostic value of SLNB in clinically neck-negative T1-2 OSCC. METHODS A systematic literature search for relevant literature published up to September 11, 2016 was conducted in PubMed, Embase, Web of Science, Cochrane Library and ClinicalTrials, and the reference lists of eligible studies were examined. Data from different studies were pooled to estimate the summary sentinel lymph node(SLN) identification rate, sensitivity, negative predictive value. Summary receiver operator characteristic curve(SROC) was plotted and area under the SROC curve (AUC) was calculated to evaluate the overall diagnostic efficacy. Threshold effect was assessed with use of the spearman correlation coefficient. Between-study heterogeneity was tested using the Q tests and the I2 statistics. Subgroup analyses were conducted in view of the greater effect of different study characteristics on diagnostic efficacy of SLN. Deeks' funnel plot asymmetry test was performed to evaluate publication bias. Sensitivity analysis was evaluated through omitting studies one by one and comparing the pooled results of random-effects model and fixed-effects model. All analyses were performed using Review Manager (version 5.3.5), Meta-DiSc (version 1.4), Comprehensive Meta Analysis (version 2.0) and STATA (version 12). RESULTS 66 studies comprising 3566 patients with cT1-2N0 OSCC were included in this meta-analysis. The pooled SLN identification rate was 96.3%(95% CI: 95.3%-97.0%). The pooled sensitivity was 0.87 (95% CI: 0.85-0.89), pooled negative predictive value was 0.94 (95% CI: 0.93-0.95), and AUC was 0.98 (95% CI: 0.97-0.99). Subgroup analyses indicated that SLN assessment with immunohistochemistry(IHC) achieved a significantly higher sensitivity than without IHC. CONCLUSIONS This meta-analysis suggests that SLNB has a high diagnostic accuracy in cT1-2N0 oral squamous cell carcinoma, and is an ideal alternative to elective neck dissection. Furthermore, the use of IHC can significantly improve SLNB diagnostic sensitivity for early OSCC.
Collapse
Affiliation(s)
- Muyuan Liu
- Department of Head and Neck, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Steven J. Wang
- Department of Otolaryngology-Head and Neck Surgery, University of Arizona College of Medicine, Tucson, Arizona, United States of America
| | - Xihong Yang
- Department of Head and Neck, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Hanwei Peng
- Department of Head and Neck, Cancer Hospital of Shantou University Medical College, Shantou, China
- * E-mail:
| |
Collapse
|
31
|
Murakami R, Nakayama H, Semba A, Hiraki A, Nagata M, Kawahara K, Shiraishi S, Hirai T, Uozumi H, Yamashita Y. Prognostic impact of the level of nodal involvement: retrospective analysis of patients with advanced oral squamous cell carcinoma. Br J Oral Maxillofac Surg 2017; 55:50-55. [DOI: 10.1016/j.bjoms.2016.08.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 08/31/2016] [Indexed: 01/02/2023]
|
32
|
Orabona GD, Bonavolontà P, Maglitto F, Friscia M, Iaconetta G, Califano L. Neck dissection versus “watchful-waiting” in early squamous cell carcinoma of the tongue our experience on 127 cases. Surg Oncol 2016; 25:401-404. [DOI: 10.1016/j.suronc.2016.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/06/2016] [Accepted: 09/21/2016] [Indexed: 10/21/2022]
|
33
|
Abdul-Razak M, Chung H, Wong E, Palme C, Veness M, Farlow D, Coleman H, Morgan G. Sentinel lymph node biopsy for early oral cancers: Westmead Hospital experience. ANZ J Surg 2016; 87:65-69. [PMID: 27878928 DOI: 10.1111/ans.13853] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 06/23/2016] [Accepted: 10/18/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sentinel lymph node biopsy (SLNB) has become an alternative option to elective neck dissection (END) for early oral cavity squamous cell carcinoma (OCSCC) outside of Australia. We sought to assess the technical feasibility of SLNB and validate its accuracy against that of END in an Australian setting. METHODS We performed a prospective cohort study consisting of 30 consecutive patients with cT1-2 N0 OCSCC referred to the Head and Neck Cancer Service, Westmead Hospital, Sydney, between 2011 and 2014. All patients underwent SLNB followed by immediate selective neck dissection (levels I-III). RESULTS A total of 30 patients were diagnosed with an early clinically node-negative OCSCC (seven cT1 and 23 cT2), with the majority located on the oral tongue. A median of three (range: 1-14) sentinel nodes were identified on lymphoscintigraphy, and all sentinel nodes were successfully retrieved, with 50% having a pathologically positive sentinel node. No false-negative sentinel nodes were identified using selective neck dissection as the gold standard. The negative predictive value (NPV) of SLNB was 100%, with 40% having a sentinel node identified outside the field of planned neck dissection on lymphoscintigraphy. Of these, one patient had a positive sentinel node outside of the ipsilateral supraomohyoid neck dissection template. CONCLUSION SLNB for early OCSCC is technically feasible in an Australian setting. It has a high NPV and can potentially identify at-risk lymphatic basins outside the traditional selective neck dissection levels even in well-lateralized lesions.
Collapse
Affiliation(s)
- Muzib Abdul-Razak
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Hsiang Chung
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia
| | - Eva Wong
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia
| | - Carsten Palme
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia.,Sydney Head and Neck Institute, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Michael Veness
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - David Farlow
- Department of Nuclear Medicine, Westmead Hospital, Sydney, New South Wales, Australia
| | - Hedley Coleman
- Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, New South Wales, Australia
| | - Gary Morgan
- Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
34
|
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 2016; 274:961-968. [PMID: 27561671 PMCID: PMC5281672 DOI: 10.1007/s00405-016-4280-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/19/2016] [Indexed: 12/17/2022]
Abstract
To determine risk factors for additional non-sentinel lymph node metastases in neck dissection specimens of patients with early stage oral cancer and a positive sentinel lymph node biopsy (SLNB). A retrospective analysis of 36 previously untreated SLNB positive patients in our institution and investigation of currently available literature of positive SLNB patients in early stage oral cancer was done. Degree of metastatic involvement [classified as isolated tumor cells (ITC), micro- and macrometastasis] of the sentinel lymph node (SLN), the status of other SLNs, and additional non-SLN metastases in neck dissection specimens were analyzed. Of 27 studies, comprising 511 patients with positive SLNs, the pooled prevalence of non-SLN metastasis in patients with positive SLNs was 31 %. Non-SLN metastases were detected (available from 9 studies) in 13, 20, and 40 % of patients with ITC, micro-, and macrometastasis in the SLN, respectively. The probability of non-SLN metastasis seems to be higher in the case of more than one positive SLN (29 vs. 24 %), the absence of negative SLNs (40 vs. 19 %), and a positive SLN ratio of more than 50 % (38 vs. 19 %). Additional non-SLN metastases were found in 31 % of neck dissections following positive SLNB. The presence of multiple positive SLNs, the absence of negative SLNs, and a positive SLN ratio of more than 50 % may be predictive factors for non-SLN metastases. Classification of SLNs into ITC, micro-, and macrometastasis in the future SLNB studies is important to answer the question if treatment of the neck is always needed after positive SLNB.
Collapse
Affiliation(s)
- Inne J Den Toom
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Elisabeth Bloemena
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry (ACTA) Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Pathology, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Stijn van Weert
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry (ACTA) Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Remco de Bree
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| |
Collapse
|
35
|
Skinner OT, Boston SE, Souza CHDM. Patterns of lymph node metastasis identified following bilateral mandibular and medial retropharyngeal lymphadenectomy in 31 dogs with malignancies of the head. Vet Comp Oncol 2016; 15:881-889. [DOI: 10.1111/vco.12229] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 02/23/2016] [Accepted: 03/06/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Owen T. Skinner
- Small Animal Hospital; University of Florida; Gainesville FL USA
| | - Sarah E. Boston
- Small Animal Hospital; University of Florida; Gainesville FL USA
| | | |
Collapse
|
36
|
Hernando J, Villarreal P, Álvarez-Marcos F, García-Consuegra L, Gallego L, Junquera L. Sentinel node biopsy versus elective neck dissection. Which is more cost-effective? A prospective observational study. J Craniomaxillofac Surg 2016; 44:550-6. [DOI: 10.1016/j.jcms.2016.01.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/14/2016] [Accepted: 01/26/2016] [Indexed: 02/05/2023] Open
|
37
|
Demir D. The Role of Sentinel Lymph Node Biopsy in Head and Neck Cancers and Its Application Areas. Turk Arch Otorhinolaryngol 2016; 54:35-38. [PMID: 29392013 DOI: 10.5152/tao.2016.1129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 11/04/2015] [Indexed: 02/05/2023] Open
Abstract
The management of the clinically N0 neck in patients with head and neck cancers still remains controversial. Elective neck dissection is traditionally recommended when the subside of the head and neck, such as the oral cavity and supraglottic area, confers at least a 15-20% risk of lymphatic spread. However, elective neck dissection may cause an increase in patient morbidity and mortality rates. The emergence of sentinel lymph biopsy provides the possibility of accurate pathological staging of the cervical node with a less invasive procedure. The present review will summarize the role of sentinel lymph node biopsy and its application areas when evaluating occult metastases in patients with head and neck cancers.
Collapse
Affiliation(s)
- Deniz Demir
- Department of Otorhinolaryngology, Sakarya University School of Medicine, Sakarya, Turkey
| |
Collapse
|
38
|
Predictive factors of occult neck metastasis in patients with oral squamous cell carcinoma. Braz J Otorhinolaryngol 2015; 82:543-7. [PMID: 26749457 PMCID: PMC9444684 DOI: 10.1016/j.bjorl.2015.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/09/2015] [Accepted: 09/18/2015] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION It is well established that cervical lymph node metastasis is the most important prognostic factor in patients with oral squamous cell carcinoma of the upper aerodigestive tract. The definition of parameters and classifications that could separate patients in groups of low, intermediate and high-risk is being attempted for several years. OBJECTIVE The objective of this study was to determine possible predictive factors related to the occurrence of occult cervical lymph node metastasis through the analysis of histopathological reports of surgical specimens obtained after oral squamous cell carcinoma resection and selective neck dissections of patients initially classified as N0. METHODS This was a primary, retrospective, observational, case-control study. Histopathological reports were reviewed to determine if some findings were related to the occurrence of occult lymph node metastasis. The events analyzed were oral cavity subsites, pT-stage, muscular infiltration, desmoplasia, vascular emboli, perineural infiltration, tumor thickness and compromised margins. RESULTS Occult cervical metastasis accounted for 19.10 percent of the cases. Desmoplasia, perineural infiltration, tumor thickness and pT4a stage are predictive factors of occult neck metastasis (p-value=0.0488, 0.0326, 0.0395, 0.0488, respectively). CONCLUSION The accurate definition of predictive factors of occult cervical metastasis may guide the selection of patients that should be referred to radiotherapy, avoiding the unnecessary exposure of low-risk patients to radiation and allowing a better regional control of the disease in those of moderate or high risk.
Collapse
|
39
|
Murase R, Tanaka H, Hamakawa T, Goda H, Tano T, Ishikawa A, Hino S, Sumida T, Nakashiro K, Hamakawa H. Double sentinel lymph node mapping with indocyanine green and 99m-technetium–tin colloid in oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.05.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
40
|
Pedersen NJ, Jensen DH, Hedbäck N, Frendø M, Kiss K, Lelkaitis G, Mortensen J, Christensen A, Specht L, von Buchwald C. 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 2015; 38 Suppl 1:E1033-40. [PMID: 26040238 DOI: 10.1002/hed.24153] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The purpose of this study was to examine the diagnostic accuracy of detecting lymph node metastases and to identify predictive and prognostic clinicopathological factors in patients with oral squamous cell carcinoma (OSCC) undergoing sentinel lymph node biopsy (SLNB). METHODS All patients diagnosed with cT1 to T2N0 OSCC who underwent a diagnostic SLNB between 2007 and 2013 were included. RESULTS We identified 253 patients, of whom 27% had a positive sentinel lymph node (SLB). The false-negative rate, sensitivity, and negative predictive value (NPV) were 5%, 88%, and 95%, respectively. Patients with micrometastases as well as macrometastases had a separately, significantly shorter disease-specific survival than patients with pN0 disease. In a logistic regression model, the maximum tumor thickness, perineural invasion, and differentiation grade were independent predictive factors for the presence of metastases. CONCLUSION These data support the use of the SLNB technique as an accurate and safe staging tool in patients with OSCC with a cN0 neck. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1033-E1040, 2016.
Collapse
Affiliation(s)
- Nicklas Juel Pedersen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - David Hebbelstrup Jensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Nora Hedbäck
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Martin Frendø
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
| | - Giedrius Lelkaitis
- Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark
| | - Jann Mortensen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Christensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lena Specht
- Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
41
|
Abstract
Oral cavity squamous cell carcinoma (OC-SCC) is the most common malignancy of the head and neck (excluding nonmelanoma skin cancer). Recent trends have shown a dramatic rise in the incidence of oropharyngeal squamous cell carcinoma (OP-SCC), with a marked increase in lesions related to human papillomavirus infection. This update presents the latest evidence regarding OC-SCC and OP-SCC. In particular, the authors compare and contrast tumors at these two sites with respect to epidemiology, etiopathogenesis, clinicopathologic presentation, clinical assessment, imaging, management, and prognosis. It is important for clinicians to be aware of differences between OC-SCC and OP-SCC so that appropriate patient education and multidisciplinary care can be provided to optimize outcomes.
Collapse
Affiliation(s)
- Angela C Chi
- Professor, Division of Oral Pathology, Medical University of South Carolina, Charleston, SC
| | - Terry A Day
- Professor, Wendy and Keith Wellin Endowed Chair for Head and Neck Oncology, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
| | - Brad W Neville
- Distinguished University Professor, Division of Oral Pathology, Medical University of South Carolina, Charleston, SC
| |
Collapse
|
42
|
Salazar-Fernandez CI, Gallana-Alvarez S, Pereira S, Cambill T, Infante-Cossio P, Herce-Lopez J. Sentinel Lymph Node Biopsy in Oral and Oropharyngeal Squamous Cell Carcinoma: Statistical Validation and Impact of Micrometastasis Involvement on the Neck Dissection Decision. J Oral Maxillofac Surg 2015; 73:1403-9. [DOI: 10.1016/j.joms.2015.01.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 01/25/2015] [Accepted: 01/25/2015] [Indexed: 02/05/2023]
|
43
|
Oral cavity squamous cell carcinoma: factors related to occult lymph node metastasis. Braz J Otorhinolaryngol 2015; 81:248-54. [PMID: 25890681 PMCID: PMC9452252 DOI: 10.1016/j.bjorl.2015.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 07/06/2014] [Indexed: 02/06/2023] Open
Abstract
Introduction Elective neck dissection is recommended in cases of oral cavity squamous cell carcinoma without lymph node metastasis because of the risk of occult metastasis. Objective The present study aimed to evaluate predictive factors for occult lymph node metastasis in patients with oral cavity squamous cell carcinoma treated with elective neck dissection and their impact on overall and disease-free survival. Methods Forty surgically treated patients were retrospectively included. Results Ten cases (25%) had lymphatic metastasis. Of the studied variables, perineural and angiolymphatic invasion in addition to tumor thickness were statistically associated with lymph node metastasis. Only angiolymphatic invasion was identified as an independent risk factor for occult metastasis in the logistic regression (OR = 39.3; p = 0.002). There was no association between overall and disease-free survival with the presence of occult lymph node metastasis. Conclusion Metastatic disease rate was similar to that found in the literature. Perineural and angiolymphatic invasion and tumor thickness were associated with occult metastasis, but only angiolymphatic invasion showed to be an independent risk factor
Collapse
|
44
|
Sentinel lymph node biopsy in oral and oropharyngeal squamous cell carcinoma: current status and unresolved challenges. Eur J Nucl Med Mol Imaging 2015; 42:1469-80. [PMID: 25916741 DOI: 10.1007/s00259-015-3049-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/15/2015] [Indexed: 12/14/2022]
Abstract
Because imaging with ultrasound, computed tomography, magnetic resonance imaging or positron emission tomography is unreliable for preoperative lymph node staging of early-stage oral and oropharyngeal squamous cell carcinoma (OSCC), elective neck dissection has been typically performed. The targeted sampling of sentinel lymph nodes (SLN) identified by lymphoscintigraphy and detected by gamma probe has become an effective alternative for the selection of patients for regional nodal resection. With careful consideration to technique, high SLN detection rates have been reported. Advanced techniques including intraoperative handheld gamma camera imaging and freehand single photon emission computed tomography (SPECT) are expected to increase surgical confidence in these procedures. This review gives an update on SLN biopsy in patients with OSCC including clinical standards and controversial aspects.
Collapse
|
45
|
Heuveling DA, van Weert S, Karagozoglu KH, de Bree R. Evaluation of the use of freehand SPECT for sentinel node biopsy in early stage oral carcinoma. Oral Oncol 2015; 51:287-90. [DOI: 10.1016/j.oraloncology.2014.12.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 11/28/2014] [Accepted: 12/01/2014] [Indexed: 02/06/2023]
|
46
|
Sentinel lymph node biopsy versus elective neck dissection in evaluation of cN0 neck in patients with oral and oropharyngeal squamous cell carcinoma. Systematic review and meta-analysis study. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.ejenta.2014.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
47
|
Forghani R, Yu E, Levental M, Som PM, Curtin HD. Imaging evaluation of lymphadenopathy and patterns of lymph node spread in head and neck cancer. Expert Rev Anticancer Ther 2014; 15:207-24. [PMID: 25385488 DOI: 10.1586/14737140.2015.978862] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Accurate and consistent characterization of metastatic cervical adenopathy is essential for the initial staging, treatment planning and surveillance of head and neck cancer patients. While enlarged superficial nodes may be clinically palpated, imaging allows identification of deeper adenopathy as well as clinically unsuspected pathology and thus imaging has become an integral part of the evaluation of most head and neck cancers patients. This review will focus on the evaluation of cervical adenopathy, summarizing the currently used nomenclature and imaging approach for determining cervical lymph node metastases in head and neck malignancies. The imaging-based classification, which has also been adopted by the American Joint Committee on Cancer, will be presented, the morphologic characteristics used to identify metastatic nodes will be reviewed and the typical nodal spread patterns of the major mucosal cancers of the head and neck will be examined.
Collapse
Affiliation(s)
- Reza Forghani
- Department of Radiology, Jewish General Hospital and McGill University, Room C-212.1, 3755 Cote Ste-Catherine Road, Montreal, Quebec, Canada
| | | | | | | | | |
Collapse
|
48
|
Hernando J, Villarreal P, Alvarez-Marcos F, Gallego L, García-Consuegra L, Junquera L. Comparison of related complications: sentinel node biopsy versus elective neck dissection. Int J Oral Maxillofac Surg 2014; 43:1307-12. [PMID: 25128262 DOI: 10.1016/j.ijom.2014.07.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 07/16/2014] [Accepted: 07/18/2014] [Indexed: 02/05/2023]
Abstract
Sentinel node biopsy (SNB) is considered a feasible neck staging tool in early oral squamous cell carcinoma. The aim of this study was to compare postoperative morbidity in patients who had undergone SNB and elective neck dissection (END). Seventy-three consecutive patients were included between the years 2005 and 2009. The patients were divided into two groups according to neck management: SNB and END groups. Kaplan-Meier survival analysis was used to compare disease-free survival (DFS) and overall survival (OS) between the groups. Shoulder function, length of the surgical scar, and the degree of cervical lymphoedema were assessed. Neck haematoma and the presence of oro-cervical communication were also analyzed. Thirty-two patients underwent SNB and 41 underwent an END (levels I-III). Seven regional recurrences were recorded in the END group. Three neck recurrences occurred in the SNB group. No significant differences were found in DFS or OS between the groups. There were statistically significant differences between the groups in shoulder function and average scar length. However, differences in degree of lymphoedema were not statistically significant. Neck hematomas and oro-cervical communications occurred only in the END group. From this study, it can be concluded that SNB presents less postoperative morbidity than END.
Collapse
Affiliation(s)
- J Hernando
- Department of Oral and Maxillofacial Surgery, Donostia University Hospital, San Sebastián, Spain
| | - P Villarreal
- Oral and Maxillofacial Surgeon, Private Practice, Oviedo, Spain
| | - F Alvarez-Marcos
- Department of Surgery, University Central Hospital, Oviedo, Spain
| | - L Gallego
- Department of Oral and Maxillofacial Surgery, Cabueñes Hospital, Gijón, Spain
| | - L García-Consuegra
- Department of Oral and Maxillofacial Surgery, University Central Hospital, Oviedo, Spain
| | - L Junquera
- Department of Oral and Maxillofacial Surgery, University Central Hospital, Oviedo, Spain.
| |
Collapse
|
49
|
Matsuzuka T, Suzuki M, Saijo S, Matsui T, Nomoto Y, Ikeda M, Tada Y, Nomoto M, Omori K. Usefulness of sentinel node navigation surgery in the management of early tongue cancer. Auris Nasus Larynx 2014; 41:475-8. [PMID: 24913730 DOI: 10.1016/j.anl.2014.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 04/30/2014] [Accepted: 05/02/2014] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine the validity of sentinel node navigation surgery (SNNS) in early stage tongue cancer, the occurrence rate of postoperative cervical metastasis (POCM) after lead plate technique (LPT) introduction and survival rates in patients who underwent SNNS were analyzed. METHODS SNNS was performed in 29 patients (stage I: 14, stage II: 15) from 2000 to 2007. Tc-labeled phytate was prepared as a radiotracer a day before SNNS. The sentinel node (SN) was then examined pathologically during surgery. For cases where metastasis in SN was positive, neck dissection was performed. Occurrence of POCM after LPT introduction was compared with that before LPT introduction. 'Wait and see' policy was performed in 52 patients (stage I: 27, stage II: 25) from 1987 to 1999 as a historical control. The observation period of SNNS cases and 'wait and see' policy cases ranged from 10 months to 165 months (median: 91 months) and from 7 months to 268 months (median: 87 months), respectively. RESULTS Six of the 29 SNNS cases (21%) were proven metastatic SNs. Before LPT introduction, POCM occurred in 2 of the 15 cases, while we had no occurrences after LPT introduction. The 5-year overall survival rate of the 29 patients who underwent SNNS and the 52 patients with 'wait and see' policy were 96% and 84%, respectively, and there was statistical significance in the two groups (p<0.05). CONCLUSIONS As the survival rate of the patients with the SNNS tended to be better than that with the 'wait and see' policy in our cases, SNNS could avoid unnecessary neck dissection. SNNS provides useful information regarding decision-making for neck dissection in early stage tongue cancer.
Collapse
Affiliation(s)
- Takashi Matsuzuka
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan
| | - Masahiro Suzuki
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan
| | - Satoshi Saijo
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan
| | - Takamichi Matsui
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan
| | - Yukio Nomoto
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan
| | - Masakazu Ikeda
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan
| | - Yasuhiro Tada
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan
| | - Mika Nomoto
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan
| | - Koichi Omori
- Department of Otolarynogology, Fukushima Medical University School of Medicine, Japan.
| |
Collapse
|
50
|
Omura K. Current status of oral cancer treatment strategies: surgical treatments for oral squamous cell carcinoma. Int J Clin Oncol 2014; 19:423-30. [DOI: 10.1007/s10147-014-0689-z] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Indexed: 12/21/2022]
|