European Journal of Biomedical and Pharmaceutical Sciences

IMPORTANCE OF SENTINEL LYMPH NODE BIOPSY IN ORAL CANCER - A REVIEW

Xavier Pradeep D’Mello A*, Shiny Jasphin, Ramya V, Sudeep D’Mello A and Prashanth Kumar K.

ABSTRACT

The status of the regional lymphatics is one of the most important prognostic parameters in patients with head and neck cancer for treatment and survival. Currently popular approach to the problem of node dissection associated morbidity is to restrict node biopsy to one or a very small number of nodes—a technique known as sentinel lymph node biopsy (SLNB). The sentinel lymph node (SLN) is defined as the lymph node on the direct drainage pathway from the primary tumor. In the past decade, the technique of SLNB has been applied to a vast array of primary neoplasm, ranging from head and neck melanoma to vulvar carcinoma. Multiple validation studies in the context of elective neck dissections revealed sentinel node detection rates above 95% and negative predictive values for negative sentinel nodes of 95%. Lymphoscintigraphy (LSG) and gamma probe-guided localization have emerged as useful techniques for identification of the SLN later confirmed with histologic and immunohistochemical analysis. SLNB is a cost-effective technique but its use in clinical practice is still limited. SLNB in head and neck squamous cell carcinoma (HNSCC) is probably considered a best investigational technique and its role continues to generate considerable debate at this time.

Keywords: Cancer, Lymphoscintigraphy, Melanoma, Neck dissection, Sentinel Lymph node.