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ACTA OTO-LARYNGOLOGICA, vol.1, no.1, pp.1-6, 2025 (SCI-Expanded, Scopus)
Sentinel lymph node biopsy (SLNB) is increasingly used in oral cavity squamous cell carcinoma (OCSCC) as a minimally invasive approach that may reduce overtreatment and morbidity compared to elective neck dissection (END).
This study evaluated the diagnostic performance of SLNB in clinically node-negative (cN0) OCSCC and its utility in mapping lymphatic drainage, particularly in advanced tumors.
A retrospective cohort of 57 cN0 OCSCC patients undergoing SLNB followed by completion neck dissection was analysed.
In early-stage tumors (T1/T2), SLNB demonstrated 100% sensitivity and negative predictive value, with an occult metastasis rate of 23.8%. No false negatives were observed, and only one patient was upstaged. In T3/T4 tumors, sensitivity and NPV decreased to 55.6% and 60%. The false-negative rate (FNR), calculated as the proportion of false negatives among patients with histopathologically confirmed nodal metastases, was 44.4%. Contralateral or bilateral drainage occurred in 40% of well-lateralized advanced tumors, reflecting altered drainage with progression.
SLNB is a reliable staging tool in early OCSCC. In advanced disease, although diagnostic accuracy is reduced, it provides valuable information on atypical drainage pathways.