Joint Practice Guidelines for Radionuclide Lymphoscintigraphy for Sentinel Node Localization in Oral/Oropharyngeal Squamous Cell Carcinoma

Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/oropharyngeal squamous cell carcinoma (OSCC), and the decision of whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method for determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histologic nodal staging and avoids overtreating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This document is designed to outline the current best practice guidelines for the provision of SNB in patients with early-stage OSCC, and to provide a framework for the currently evolving recommendations for its use. Preparation of this guideline was carried out by a multidisciplinary surgical/nuclear medicine/pathology expert panel under the joint auspices of the European Association of Nuclear Medicine (EANM) Oncology Committee and the Sentinel European Node Trial (SENT) Committee.

[Methods in the evaluation of medical students]

The achievements of medical students are decisively dependent on the method of evaluation during their education. Frequent testing of these achievements by well-defined (cross-specialized) problems (involving cases) enables the student to quickly correct own knowledge- or skills-deficiencies, while the relevance of the curriculum is further visualized. A differentiated panel of tests evaluates both the students individual study methods and her ability to make clinical inquiry, diagnoses and application of practical skills. An insufficient individual performance graded by known minimal specific standards entails a feedback session with a counsellor who pin-points defects in the student's knowledge and suggests methods for correction. This form of evaluation is expected to be costly, but is a necessity to improve the quality of the graduating medical students.