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International Journal of Clinical Oncology

Erschienen in:

16.02.2023 | Original Article

Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer

verfasst von: Takahito Kondo, Kiyoaki Tsukahara, Daisuke Kawakita, Seiichi Yoshimoto, Kouki Miura, Masashi Sugasawa, Kazuaki Chikamatsu, Takashi Matsuzuka, Isao Oze, Morimasa Kitamura, Yoshiko Murakami, Shinji Otozai, Takeshi Shinozaki, Shinichi Ohba, Koji Araki, Takatsugu Mizumachi, Dai Sato, Naohiro Wakisaka, Hitoshi Hirakawa, Yasuhisa Hasegawa

Erschienen in: International Journal of Clinical Oncology | Ausgabe 4/2023

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Abstract

Background

A multicenter, randomized controlled phase III trial was conducted on sentinel lymph node biopsy (SLNB) and elective neck dissection for T1 (depth of invasion ≥ 4 mm)–T2N0M0 oral cavity squamous cell carcinoma. This study identified factors associated with poor prognosis in patients who underwent SLNB based on a subgroup analysis of this trial.

Methods

We analyzed 418 sentinel lymph nodes (SLNs) from 132 patients who underwent SLNB. The metastatic SLNs were classified into three categories based on size-isolated tumor cells: < 0.2 mm, micrometastasis: ≥ 0.2 mm and < 2 mm, and macrometastasis: ≥ 2 mm. Three groups were formed based on the number of metastatic SLNs: no metastasis, 1 metastatic node, and ≥ 2 metastatic nodes. The size and number of metastatic SLNs on survival were evaluated using Cox proportional hazard models.

Results

Patients with macrometastasis and ≥ 2 metastatic SLNs had worse overall survival (OS) and disease-free survival (DFS) after adjustment for potential confounders (HR for OS: macrometastasis, 4.85; 95% CI 1.34–17.60; ≥ 2 metastatic SLN, 3.63; 95% CI 1.02–12.89; HR for DFS: macrometastasis, 2.94; 95% CI 1.16–7.44; ≥ 2 metastatic SLN, 2.97; 95% CI 1.18–7.51).

Conclusions

In patients who underwent SLNB, a poorer prognosis was associated with macrometastasis or having ≥ 2 metastatic SLNs.

Nur mit Berechtigung zugänglich

D’Cruz AK, Vaish R, Kapre N et al (2015) Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med 373:521–529CrossRefPubMed

Hasegawa Y, Tsukahara K, Yoshimoto S et al (2021) Neck dissections based on sentinel lymph node navigation versus elective neck dissections in early oral cancers: a randomized, multicenter, and noninferiority trial. J Clin Oncol 39:2025–2036CrossRefPubMed

Kaul P, Majumdar K, Kumar R et al (2021) Isolated tumor cells in sentinel lymph nodes: a management dilemma. J Clin Oncol 39:3517–3518CrossRefPubMed

Hasegawa Y, Tsukahara K, Yoshimoto S et al (2021) Reply to P. Kaul et al. J Clin Oncol 39:3518–3519CrossRefPubMed

Miura K, Hirakawa H, Uemura H et al (2017) Sentinel node biopsy for oral cancer: a prospective multicenter phase II trial. Auris Nasus Larynx 44:319–326CrossRefPubMed

Hermanek P, Hutter RV, Sobin LH et al (1999) International Union Against Cancer. Classification of isolated tumor cells and micrometastasis. Cancer 86:2668–2673CrossRefPubMed

Alex JC, Krag DN (1996) The gamma-probe-guided resection of radiolabeled primary lymph nodes. Surg Oncol Clin N Am 5:33–41CrossRefPubMed

de Bree R, de Keizer B, Civantos FJ et al (2021) What is the role of sentinel lymph node biopsy in the management of oral cancer in 2020? Eur Arch Otorhinolaryngol 278:3181–3191CrossRefPubMed

de Boer M, van Deurzen CH, van Dijck JA et al (2009) Micrometastases or isolated tumor cells and the outcome of breast cancer. N Engl J Med 361:653–663CrossRefPubMed

10.

Leidenius MH, Vironen JH, Heikkilä PS et al (2010) Influence of isolated tumor cells in sentinel nodes on outcome in small, node-negative (pT1N0M0) breast cancer. Ann Surg Oncol 17:254–262CrossRefPubMed

11.

Broglie MA, Haerle SK, Huber GF et al (2013) Occult metastases detected by sentinel node biopsy in patients with early oral and oropharyngeal squamous cell carcinomas: impact on survival. Head Neck 35:660–666CrossRefPubMed

12.

Schilling C, Stoeckli SJ, Haerle SK et al (2015) Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer 51:2777–2784CrossRefPubMed

13.

Pedersen NJ, Jensen DH, Hedbäck N et al (2016) Staging of early lymph node metastases with the sentinel lymph node technique and predictive factors in T1/T2 oral cavity cancer: a retrospective single-center study. Head Neck 38(Suppl 1):E1033-1040CrossRefPubMed

14.

Garrel R, Poissonnet G, Moyà PA et al (2020) Equivalence randomized trial to compare treatment on the basis of sentinel node biopsy versus neck node dissection in operable T1–T2N0 oral and oropharyngeal cancer. J Clin Oncol 38:4010–4018CrossRefPubMed

15.

Chone CT, Aniteli MB, Magalhães RS et al (2013) Impact of immunohistochemistry in sentinel lymph node biopsy in head and neck cancer. Eur Arch Otorhinolaryngol 270:313–317CrossRefPubMed

16.

Den Toom IJ, Bloemena E, van Weert S et al (2017) Additional non-sentinel lymph node metastases in early oral cancer patients with positive sentinel lymph nodes. Eur Arch Otorhinolaryngol 274:961–968CrossRef

17.

National Comprehensive Cancer Network guidelines, Head and Neck Cancers, version 2.2022. https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf. Accessed Oct 2022

Titel: Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer
verfasst von: Takahito Kondo
Kiyoaki Tsukahara
Daisuke Kawakita
Seiichi Yoshimoto
Kouki Miura
Masashi Sugasawa
Kazuaki Chikamatsu
Takashi Matsuzuka
Isao Oze
Morimasa Kitamura
Yoshiko Murakami
Shinji Otozai
Takeshi Shinozaki
Shinichi Ohba
Koji Araki
Takatsugu Mizumachi
Dai Sato
Naohiro Wakisaka
Hitoshi Hirakawa
Yasuhisa Hasegawa
Publikationsdatum: 16.02.2023
Verlag: Springer Nature Singapore
Erschienen in: International Journal of Clinical Oncology / Ausgabe 4/2023
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-023-02305-1

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Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer