Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes

Research output: Contribution to journalArticleAcademicpeer-review

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.

LanguageEnglish
Pages961-968
Number of pages8
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume274
Issue number2
DOIs
Publication statusPublished - 1 Feb 2017

Cite this

@article{fb8a24471be64169950fc6da7a0445b4,
title = "Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes",
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.",
keywords = "Lymph nodes, Lymphatic metastasis, Mouth neoplasms, Neck dissection, Neoplasm micrometastasis, Sentinel lymph node biopsy",
author = "{Den Toom}, {Inne J.} and Elisabeth Bloemena and {van Weert}, Stijn and Karagozoglu, {K. Hakki} and Hoekstra, {Otto S.} and {de Bree}, Remco",
year = "2017",
month = "2",
day = "1",
doi = "10.1007/s00405-016-4280-2",
language = "English",
volume = "274",
pages = "961--968",
journal = "European Archives of Oto-Rhino-Laryngology",
issn = "0937-4477",
publisher = "Springer Verlag",
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}

Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes. / Den Toom, Inne J.; Bloemena, Elisabeth; van Weert, Stijn; Karagozoglu, K. Hakki; Hoekstra, Otto S.; de Bree, Remco.

In: European Archives of Oto-Rhino-Laryngology, Vol. 274, No. 2, 01.02.2017, p. 961-968.

Research output: Contribution to journalArticleAcademicpeer-review

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

PY - 2017/2/1

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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.

AB - 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.

KW - Lymph nodes

KW - Lymphatic metastasis

KW - Mouth neoplasms

KW - Neck dissection

KW - Neoplasm micrometastasis

KW - Sentinel lymph node biopsy

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U2 - 10.1007/s00405-016-4280-2

DO - 10.1007/s00405-016-4280-2

M3 - Article

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EP - 968

JO - European Archives of Oto-Rhino-Laryngology

T2 - European Archives of Oto-Rhino-Laryngology

JF - European Archives of Oto-Rhino-Laryngology

SN - 0937-4477

IS - 2

ER -