Predictive factors for failure to identify sentinel nodes in head and neck squamous cell carcinoma

Head Neck. 2008 Jul;30(7):858-62. doi: 10.1002/hed.20787.

Abstract

Background: The aim of this study was to ascertain which factors determine success of sentinel node biopsy (SNB).

Methods: We conducted a retrospective review of 121 patients with head and neck squamous cell carcinoma undergoing SNB to stage the neck. All patients underwent the triple-diagnostic procedure of preoperative lymphoscintigraphy, intraoperative blue dye, and a gamma probe. Factors contributing to failure of SNB were identified.

Results: SNB was unsuccessful in 12 of 121 patients (10%). Seven of the 12 patients had cT1/cT2 tumors, and 6 of these were located in the floor of mouth. SN identification was more likely to be successful in patients with cN0 necks, but this did not reach statistical significance (92% vs 84%, p = .268). Factors associated with failure included T classification (p = .01), tumor site (p = .05), and negative preoperative lymphoscintigraphy (p = .0174).

Conclusion: Successful sentinel lymph node harvest is related to primary tumor site, T classification, and the presence of nodes on preoperative lymphoscintigraphy.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery
  • Chi-Square Distribution
  • Cohort Studies
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Immunohistochemistry
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology*
  • Neoplasm Staging
  • Predictive Value of Tests
  • Preoperative Care / methods
  • Probability
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Sentinel Lymph Node Biopsy*
  • Survival Analysis
  • Treatment Failure
  • Treatment Outcome