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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2009

01-02-2009 | Head and Neck Oncology

Positive Sentinel Lymph Nodes are a Negative Prognostic Factor for Survival in T1-2 Oral/Oropharyngeal Cancer—A Long-Term Study on 103 Patients

Authors: Adorján F. Kovács, MD, DMD, PhD, Ulrich Stefenelli, Oliver Seitz, MD, Marcus Middendorp, MD, Jürgen Diener, Robert Sader, MD, DMD, PhD, Frank Grünwald, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2009

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Abstract

Background

To evaluate prognostic value of sentinel node biopsy (SNB) in oral/oropharyngeal squamous cell cancer (OOSCC) concerning overall/disease-free survival.

Methods

One hundred three consecutive patients with T1-2N0 OOSCC were consecutively recruited for SNB as single invasive staging method for the neck. Two hundred seventy-three sentinel nodes (SNs) were removed (mean, 2.65 per patient). Nine patients had 10 positive SNs (upstaging rate, 8.7%) found in levels I to III, leading to a therapeutic neck dissection.

Results

Mean observation time of all patients was 6.7 years; mean survival time of patients with negative or positive SNs was 6.9 and 3.7 years, respectively. There has been no false-negative result of SNB to date becoming manifest in ipsilateral node metastasis during follow-up. Five-year overall/disease-free survival of all patients was 82%/72%, respectively. The same parameters for the patients with negative SNs were 85%/74%, for those with positive SNs 38%/47%, respectively (statistically significant). There has been a higher statistical risk for locoregional recurrence for patients with positive SNs. Rates of metachronous second primary tumors developing during follow-up were 10.6% (negative SNs) and 44.4% (positive SNs).

Conclusion

SNB was a valuable diagnostic method in patients with T1-2N0 OOSCC avoiding elective neck dissections. Patients with positive SNs had statistically significantly higher rates of locoregional recurrences, second primary tumors, tumor-related deaths, and a worse overall/disease-free survival. To date, no therapeutic consequences in case of a positive SN beyond execution of modified radical neck dissection (to remove other positive nodes) and closer attention during follow-up can be concluded from this study.
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Metadata
Title
Positive Sentinel Lymph Nodes are a Negative Prognostic Factor for Survival in T1-2 Oral/Oropharyngeal Cancer—A Long-Term Study on 103 Patients
Authors
Adorján F. Kovács, MD, DMD, PhD
Ulrich Stefenelli
Oliver Seitz, MD
Marcus Middendorp, MD
Jürgen Diener
Robert Sader, MD, DMD, PhD
Frank Grünwald, MD, PhD
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-0150-5

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