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KMID : 1134220090290030255
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Hanyang Medical Reviews
2009 Volume.29 No. 3 p.255 ~ p.264
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Sentinel Lymph Node Biopsy in the Oral Cavity Cancer
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Baek Chung-Hwan
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Abstract
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Elective neck dissection for the clinically nodenegative neck is targeted to diagnose and eradicate the occult lymph node metastasis. However, this elective neck dissection gives unnecessary risk of complication and morbidity. Therefore, the extent of the elective neck dissection tends to be reduced to minimize the postoperative morbidity. The sentinel lymph node biopsy has been developed for this purpose. Sentinel lymph node is the first lymph node that gets lymphatic drainage from the tumor. Evaluation of this sentinel lymph node enables the prediction of the presence of occult lymph node metastasis. If the biopsy of the sentinel lymph node shows no metastasis, additional neck dissection can be avoided, which reduces the postoperative morbidity. There have been clinical studies on the sentinel lymph node biopsy for the head and neck squamous cell carcinoma, in which the diagnostic accuracy has been reported to be 95-100%. We
started sentinel lymph node biopsy for the clinically node-negative, early-staged oral cavity cancer in December 2002. From 2002 to 2004, we evaluated its diagnostic accuracy. The positive predictive value and the negative predictive value were 100% and 98.5%, respectively. We currently determine the elective neck dissection according to the result
of the sentinel lymph node biopsy.
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KEYWORD
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Sentinel lymph node, Oral cavity cancer, Neck dissection, Occult metastasis
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