The first and second echelon sentinel lymph node evaluation in oral cancer.

Sentinel lymph node biopsy shows promise as a minimally invasive technique that samples the first echelon (station) of nodes to predict the need for more extensive neck dissection. This paper discusses the accuracy and feasibility of sentinel node and "station II node" biopsy for predicting the status of neck in 20 patients of oral cancer. We identified sentinel node in these patients. The next higher-order nodes, that is, second echelon of nodes known as "station II nodes" were delineated by further injecting 0.1 ml of isosulfan blue dye in sentinel lymph node. Identification rate for station I nodes was 95 %. Station II nodes were identified in 84 % of patients. One patient had false negative station I node. Station II node status was false negative in two patients. "Station I and station II concept" is feasible in early-stage tumors of oral cavity.