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Systematic Review



Sentinel Lymph Node Biopsy in Head Neck Cancer: A Systematic Review

Basant Mohan Singhal, Ashok Kumar Singh, Vishal Kewlani, Rahul Singh, Santosh Kumar Singh.




Abstract
Cited by 0 Articles

Introduction:
In the management of SCC of the Head and Neck (H N) region, lymph node metastases is considered one of the most significant negative prognostic factor. Elective Surgery i.e Elective Neck Dissection (END) is considered standard and optimum management policy in early stage clinically node-negative (cN0) oral and oropharyngeal SCC, as even modern imaging modalities are not able to reliably detect or exclude occult micrometastases. Surgical treatment options for cervical lymph node metastases are associated with significant morbidities like impairment of shoulder function and contour changes, lower lip parasthesia, postoperative neck stiffness, nerve injury, and pain. Radiation treatment of the neck is associated with skin reactions, xerostomia, dysphagia, carotid artery stenosis, and hypothyroidism. The objective of our study is to systematically review published literature regarding the application of the Sentinel Lymph Node Biopsy (SLNB) technique in clinically node-negative(cN0) patients of early HN Squamous Cell Cancers (SCC).
Material And Methods –
A systematic review of available publications and their references was done, and all relevant articles were included in this review.
Discussion –
Many authors reported better Overall Survival (OS), Disease Specific Survival (DSS), and Disease Free Survival (DFS) when the SLNB protocol was used. The only disadvantage could be that Free Soft Tissue Disease in the neck in the absence of lymph node involvement can be missed.
Conclusion –
Recently published results on SLNB by various Trials, Meta-analyses, and Systematic Reviews have presented it as a promising alternative to conventional methods of Neck management in cN0 HN cancers. It may decrease morbidity associated with radical surgery or radiotherapy and ensure a better quality of life in a select group of HN cancer patients.

Key words: Sentinel Lymph Node Biopsy, Head neck Cancer, Occult Metastases, elective Neck dissection






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