Survival in node-positive early oral squamous cell carcinoma: sentinel node biopsy versus elective neck dissection


      Patients undergoing sentinel node biopsy (SLNB) for early oral squamous cell carcinoma (OSCC) who harbour occult metastases (pN+ve) may be at greater risk of mortality due to prolonged overall treatment times than those identified as pN+ve on elective neck dissection (ELND). A retrospective comparative survival analysis was therefore undertaken to test this hypothesis. Patients were identified from the South Glasgow multidisciplinary team (MDT) database. Group 1 comprised 38 patients identified as pN+ve, or who were false negative, on sentinel lymph node biopsy (SLNB). Group 2 comprised 146 patients staged pN+ve on ELND. The groups were compared with the Kaplan Meier method and Cox proportional hazards model. In addition, a matched-pair analysis was performed. A unique and specifically designed algorithm was deployed to optimise the pairings. No difference in disease-specific or overall survival was found between the groups. Patients undergoing SLNB as the initial neck staging modality in early OSCC and are identified as pN+ve do not appear to be at a survival disadvantage compared with those staged with ELND.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Vassiliou L.V.
        • Acero J.
        • Gulati A.
        • et al.
        Management of the clinically N0 neck in early-stage oral squamous cell carcinoma (OSCC). An EACMFS position paper.
        J Craniomaxillofac Surg. 2020; 48: 711-718
        • Garrel R.
        • Poissonnet G.
        • Plana A.M.
        • et al.
        Equivalence randomized trial to compare treatment on the basis of sentinel node biopsy versus neck node dissection in operable T1–T2 N0 oral and oropharyngeal cancer.
        J Clin Oncol. 2020; 38: 4010-4018
        • Hasegawa Y.
        • Tsukahara K.
        • Yoshimoto S.
        • et al.
        Neck dissections based on sentinel lymph node navigation versus elective neck dissections in early oral cancers: a randomized, multicenter, and non-inferiority trial.
        J Clin Oncol. 2021; 39: 2025-2036
        • McMahon J.D.
        • Pitts R.
        • Isbister J.
        • et al.
        Postoperative risk stratification in oral squamous cell carcinoma.
        Br J Oral Maxillofac Surg. 2020; 58: 462-468
        • Peduzzi P.
        • Concato J.
        • Feinstein A.R.
        • et al.
        Importance of events per independent variable in proportional hazards regression analysis II. Accuracy and precision of regression estimates.
        J Clin Epidemiol. 1995; 48: 1503-1510
        • den Toom I.J.
        • Boeve K.
        • Lobeek D.
        • et al.
        Elective neck dissection or sentinel lymph node biopsy in early stage oral cavity cancer patients: the Dutch experience.
        Cancers (Basel). 2020; 12: 1783
        • Schilling C.
        • Stoeckli S.J.
        • Haerle S.K.
        • et al.
        Sentinel European Node Trail (SENT): 3-year results of sentinel node biopsy in oral cancer.
        Eur J Cancer. 2015; 51: 2777-2784