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Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes.
Eur Arch Otorhinolaryngol. 2017 Feb; 274(2):961-968.EA

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.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry (ACTA) Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. Department of Pathology, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Center for Dentistry (ACTA) Amsterdam, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.Department of Radiology and Nuclear Medicine, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. r.debree@umcutrecht.nl. Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. r.debree@umcutrecht.nl.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27561671

Citation

Den Toom, Inne J., et al. "Additional Non-sentinel Lymph Node Metastases in Early Oral Cancer Patients With Positive Sentinel Lymph Nodes." European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, vol. 274, no. 2, 2017, pp. 961-968.
Den Toom IJ, Bloemena E, van Weert S, et al. Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes. Eur Arch Otorhinolaryngol. 2017;274(2):961-968.
Den Toom, I. J., Bloemena, E., van Weert, S., Karagozoglu, K. H., Hoekstra, O. S., & de Bree, R. (2017). Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes. European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 274(2), 961-968. https://doi.org/10.1007/s00405-016-4280-2
Den Toom IJ, et al. Additional Non-sentinel Lymph Node Metastases in Early Oral Cancer Patients With Positive Sentinel Lymph Nodes. Eur Arch Otorhinolaryngol. 2017;274(2):961-968. PubMed PMID: 27561671.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes. AU - Den Toom,Inne J, AU - Bloemena,Elisabeth, AU - van Weert,Stijn, AU - Karagozoglu,K Hakki, AU - Hoekstra,Otto S, AU - de Bree,Remco, Y1 - 2016/08/25/ PY - 2016/06/02/received PY - 2016/08/19/accepted PY - 2016/8/27/pubmed PY - 2017/4/6/medline PY - 2016/8/27/entrez KW - Lymph nodes KW - Lymphatic metastasis KW - Mouth neoplasms KW - Neck dissection KW - Neoplasm micrometastasis KW - Sentinel lymph node biopsy SP - 961 EP - 968 JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery JO - Eur Arch Otorhinolaryngol VL - 274 IS - 2 N2 - 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. SN - 1434-4726 UR - https://www.unboundmedicine.com/medline/citation/27561671/Additional_non_sentinel_lymph_node_metastases_in_early_oral_cancer_patients_with_positive_sentinel_lymph_nodes_ L2 - https://dx.doi.org/10.1007/s00405-016-4280-2 DB - PRIME DP - Unbound Medicine ER -