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European Archives of Oto-Rhino-Laryngology

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Open Access 01-02-2017 | Head and Neck

Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes

Authors: Inne J. Den Toom, Elisabeth Bloemena, Stijn van Weert, K. Hakki Karagozoglu, Otto S. Hoekstra, Remco de Bree

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2017

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.

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Title: Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes
Authors: Inne J. Den Toom
Elisabeth Bloemena
Stijn van Weert
K. Hakki Karagozoglu
Otto S. Hoekstra
Remco de Bree
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 2/2017
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-016-4280-2

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Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes

Abstract

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Abstract

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