Sentinel Lymph Node Biopsy Accurately Stages the Regional Lymph Nodes for T1-T2 Oral Squamous Cell Carcinomas: Results of a Prospective Multi-Institutional Trial

Francisco J Civantos; Robert P Zitsch; David E Schuller; Amit Agrawal; Russell B Smith; Richard Nason; Guy Petruzelli; Christine G Gourin; Richard J Wong; Robert L Ferris; Adel El Naggar; John A Ridge; Randal C Paniello; Kouros Owzar; Linda McCall; Douglas B Chepeha; Wendell G Yarbrough; Jeffrey N Myers

doi:10.1200/JCO.2008.20.8777

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Sentinel Lymph Node Biopsy Accurately Stages the Regional Lymph Nodes for T1-T2 Oral Squamous Cell Carcinomas: Results of a Prospective Multi-Institutional Trial

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Sentinel Lymph Node Biopsy Accurately Stages the Regional Lymph Nodes for T1-T2 Oral Squamous Cell Carcinomas: Results of a Prospective Multi-Institutional Trial

Francisco J Civantos, Robert P Zitsch, David E Schuller, Amit Agrawal, Russell B Smith, Richard Nason, Guy Petruzelli, Christine G Gourin, Richard J Wong, Robert L Ferris, …

Journal of clinical oncology, Vol.28(8), pp.1395-1400

2010-03-10

DOI: https://doi.org/10.1200/JCO.2008.20.8777

PMCID: PMC2834497

PMID: 20142602

Abstract

Purpose The validity of sentinel lymph node biopsy (SLNB) for T1 or T2, clinically N0, oral cancer was tested by correlation of sentinel node pathologic status with that of nodes within the completion neck dissection. Methods This prospective, cooperative group trial involved 25 institutions over a 3-year period. One hundred forty patients with invasive oral cancers, stage T1 and T2, N0 including 95 cancers of the tongue, 26 of the floor of mouth, and 19 other oral cancers were studied. The study excluded lesions with diameter smaller than 6 mm or minimal invasion. Imaging was used to exclude nonpalpable gross nodal disease. Patients underwent injection of the lesion with 99mTc-sulfur colloid, nuclear imaging, narrow-exposure SLNB, and completion selective neck dissection. The major end point was the negative-predictive value (NPV) of SLNB. Results In the 106 SLNBs, which were found to be pathologically and clinically node-negative by routine hematoxylin and eosin stain, 100 patients were found to have no other pathologically positive nodes, corresponding to a NPV of 94%. With additional sectioning and immunohistochemistry, NPV was improved to 96%. In the forty patients with proven cervical metastases, the true-positive rate was 90.2% and was superior for tongue tumors relative to floor of mouth. For T1 lesions, metastases were correctly identified in 100%. Conclusion For T1 or T2 N0 oral squamous cell carcinoma, SLNB with step sectioning and immunohistochemistry, performed by surgeons of mixed experience levels, correctly predicted a pathologically negative neck in 96% of patients (NPV, 96%).

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.179 Oncology; 1.179.377 Head And Neck Cancer
Web Of Science research areas: Oncology
ESI research areas: Clinical Medicine

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Title: Sentinel Lymph Node Biopsy Accurately Stages the Regional Lymph Nodes for T1-T2 Oral Squamous Cell Carcinomas: Results of a Prospective Multi-Institutional Trial
Creators: Francisco J Civantos - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Robert P Zitsch - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
David E Schuller - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Amit Agrawal - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Russell B Smith - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Richard Nason - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Guy Petruzelli - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Christine G Gourin - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Richard J Wong - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Robert L Ferris - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Adel El Naggar - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
John A Ridge - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Randal C Paniello - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Kouros Owzar - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Linda McCall - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Douglas B Chepeha - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Wendell G Yarbrough - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Jeffrey N Myers - From the University of Miami, Miami, FL; University of Missouri, Columbia; Washington University, St Louis, MO; The Ohio State University, Columbus, OH; University of Iowa, Iowa City, IA; University of Manitoba, Winnipeg, Canada; Loyola University, Chicago, IL; Medical College of Georgia, Augusta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Pittsburgh, Pittsburgh; Fox Chase Cancer Center, Philadelphia, PA; M. D. Anderson Cancer Center, Houston, TX; Duke University, Durham, NC
Publication Details: Journal of clinical oncology, Vol.28(8), pp.1395-1400
Academic Unit: Miller School of Medicine; UMMG Department of Otolaryngology
Language: English
Resource Type: Journal article
PMID: 20142602
PMCID: PMC2834497
Record Identifier: 991031614081802976