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Type: Journal article
Title: Sentinel node biopsy in squamous cell cancer of the oral cavity andoral pharynx: a diagnostic meta-analysis
Author: Paleri, V.
Rees, G.
Arullendran, P.
Shoaib, T.
Krishman, S.
Citation: Head and Neck: journal for the sciences and specialities of the head and neck, 2005; 27(9):739-747
Publisher: John Wiley & Sons Inc
Issue Date: 2005
ISSN: 1043-3074
Statement of
Vinidh Paleri, Guy Rees, Puveendran Arullendran, Taimur Shoaib and Suren Krishman
Abstract: <h4>Background</h4>The sentinel node biopsy concept has been gaining support in the head and neck cancer literature during only the last few years, and several pilot studies have been published. This procedure aims to avoid unnecessary treatment to the clinically negative neck by identifying the patients with occult neck disease.<h4>Methods</h4>We performed a systematic review and a diagnostic meta-analysis of all published literature regarding sentinel node biopsies in head and neck cancer until December 2003 using established guidelines. Using the pooled sensitivity rates obtained from the meta-analysis and treatment outcomes from published literature, we created a decision analysis model to identify the treatment arm with better payoffs.<h4>Results</h4>A total of 301 patients with oral cavity primary tumors and 46 patients with oropharyngeal primary tumors from 19 articles were included for the meta-analysis. The pooled sensitivity result using the random effects model was 0.926 (95% confidence interval, 0.852-0.964). The cumulative payoff for the sentinel node biopsy arm was lower than that for the elective node dissection arm by about 1%. The payoffs were assigned for the recurrence and mortality rates only and did not take into account the morbidity caused by the procedures.<h4>Conclusions</h4>The sentinel node biopsy procedure has shown high sensitivity rates in pilot studies for oral and oropharyngeal squamous cell cancer across the globe and is reliable and reproducible. This study provides a firm evidence base for forthcoming trials on the role of sentinel node biopsy in head and neck cancer.
Keywords: Humans
Carcinoma, Squamous Cell
Mouth Neoplasms
Pharyngeal Neoplasms
Neoplasm Recurrence, Local
Sentinel Lymph Node Biopsy
Lymph Node Excision
Sensitivity and Specificity
Decision Trees
DOI: 10.1002/hed.20228
Appears in Collections:Aurora harvest 2
Surgery publications

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