The shift towards more conservative surgical procedures has occurred primarily in the last 2 decades this shift was facilitated by the work undertaken by Lindberg, Byers et al. Previously, ENDs invariably took the form of a modified radical neck dissection however, there is increasing evidence that selective neck dissection is as efficacious as comprehensive neck dissection in treating the node-negative neck. In practice, END provides valuable prognostic information regarding nodal status and simultaneous treatment of those patients found to be pathologically node-positive. Further, END results in an error rate of approximately 10% in the ipsilateral neck. Unfortunately, the invasive nature of END increases the chance of surgery-induced side-effects that impair the patient’s quality of life. Thus, elective neck dissection (END) is the current standard of care. However, the predictive value of tumour depth and other primary tumour characteristics is still insufficient to negate the need for surgical staging of the cervical node basin. Over the last 2 decades, much work has been undertaken to identify reliable predictors of occult metastases, of which tumour depth appears to be the best available. Įlective treatment of the clinically node-negative neck remains a controversial topic. Cervical lymph node involvement is the most important prognostic factor for patients with OSCC. SLN procedures provide a realisable means for mapping the most likely lymphatic tumour dissemination pathways and thus aid the identification of early lymphatic lymphatic spread (micrometastases).
Sentinel node series#
The incidence of occult metastases in patients with clinically node-negative OSCC is high, with many series reporting rates greater than 30%. Determining the presence or absence of nodal metastases is of paramount importance for staging, treatment planning, and prognosis. Three-quarters of affected people are in the developing world, while in developed countries OSCC is the eighth most prevalent form of cancer. Oral squamous cell cancer (OSCC) is one of the most common cancers worldwide, accounting for more than 264,000 new cases and 128,000 deaths annually.
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