Intraoperative neck staging using sentinel node biopsy and imprint cytology in oral cancer.

BACKGROUND

Nodal status is an important prognostic factor in oral cancer. Sentinel node studies may enable accurate identification of high-risk nodes without a formal neck dissection. Imprint cytology is an emerging tool to assist in the rapid intraoperative detection of nodal metastases with encouraging results in other solid tumors. This study was planned to evaluate a novel method of intraoperative staging using sentinel node biopsy and intraoperative imprint cytology in oral cancer.

PATIENTS AND METHODS

Thirty-two cases of oral cancer underwent sentinel node mapping using 1% isosulfan blue during the study period. The sentinel node was sent for evaluation by imprint cytology. The average time taken for reporting was 15 minutes. The result was compared with the final histopathology, which was taken as the "gold standard".

RESULTS

Sentinel nodes (SLN) were identified in 30 cases (93.75% identification rate), with two false negatives. Intraoperative imprint cytology (IIC) could accurately predict the nodal status in 28 of the 30 patients. There was one false-positive result and one false-negative result. The overall sensitivity, specificity, and accuracy of IIC were 87.5%, 95.4%, and 93.3 %, respectively.

CONCLUSION

Sentinel node biopsy along with IIC provides a reliable, inexpensive, and accurate method of intraoperative identification of the nodal status in oral cancer.