Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinomacohort study and meta-analysis
- Julio Álvarez Amezaga 1
- Luis Barbier Herrero 2
- J.I. Pijoan Zubizarreta 1
- Jesús Carmelo Martín Rodríguez 1
- Laura Romo Simón 1
- Jose Genollá Subirats 1
- Gonzalo Ríos Altolaguirre 1
- Antonio de los Ríos 1
- María Iciar Arteagoitia Calvo 2
- Salvador Landa Llona 2
- J.A. Arruti 3
- José Luis López-Cedrún Cembranos 4
- Joseba Andoni Santamaría Zuazua 2
- 1 Hospital de Cruces. Bilbao
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2
Universidad del País Vasco/Euskal Herriko Unibertsitatea
info
Universidad del País Vasco/Euskal Herriko Unibertsitatea
Lejona, España
- 3 Complejo Hospitalario Donostia
- 4 Complejo Hospitalario. La Coruña
ISSN: 1698-6946
Año de publicación: 2007
Volumen: 12
Número: 3
Páginas: 14
Tipo: Artículo
Otras publicaciones en: Medicina oral, patología oral y cirugía bucal. Ed. inglesa
Resumen
Objectives: To evaluate the efficacy of sentinel node biopsy (SNB) in oral squamous cell carcinoma (OSCC). Design: A prospective study of a cohort of 25 consecutive patients with OSCC anatomopathological confirmation through biopsy, without oncological pre-treatment, in clinical stage T1-T4N0, of these 25 patients 14 were T1-T2N0. The absence of regional disease (N0) was determined by means of clinical exploration and cervical tomography (CT). To establish the overall sensitivity of the technique, a meta-analysis was carried out of 10 series published to February 2005 where SNB had been applied to head and neck cancer, adding our 14 T1-T2N0 cases, thus making a total of 260 patients. Results: Identification by SNB was accurate in 96% of the 25 cases, with a sensitivity of 66.7%. Analyzing only the T1-T2N0 cases (n=14), the accuracy was 100% with a sensitivity of 1 (CI 95%, 0.29-1.00). The overall sensitivity was 93%. The accuracy in identifying the sentinel node varied between 66% and 100%. The SN was identified in 251 of 260 cases, of those, 71 were true positive, 5 false negative and 175 true negative. The overall sensitivity was 93.4% (CI 95%, 85.3-97.8), with a specificity of 100% (CI 95%, 0.98-100). The weighted negative probability quotient was 0.176 (CI 0.103-0.301) and that of positive probability 24.75 (CI 95%, 10.8-56.71). The weighted diagnostic odds ratio was 183.71 (CI 95%, 59.36-568.56). If we accept that the prevalence of hidden regional disease is 30%, a negative sentinel node has 5% possibility of having hidden disease. Conclusions: Our data provide a certain degree of evidence that, due to its high sensitivity, the SNB procedure can be applied to the initial stages of OSCC.