Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China.
Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China.
Oral Oncol. 2024 May;152:106810. doi: 10.1016/j.oraloncology.2024.106810. Epub 2024 Apr 16.
To evaluate the oncologic safety and quality of life associated with the use of sentinel lymph node biopsy (SLNB) as compared to elective neck dissection (END) in patients with cT1/2N0 maxillary squamous cell carcinoma.
This study constituted a retrospective analysis of consecutively treated patients who underwent SLNB or END, with data collected prospectively. We analyzed the impact of the different neck procedures on regional control and disease-specific survival via the Cox model. Patients in both groups completed the University of Washington Quality of Life questionnaire.
We included a total of 130 patients, with 47 receiving SLNB. In all cases, the sentinel lymph node could be identified, and of these, 5 had a positive result, yielding a sensitivity of 83.3 %, a specificity of 100 %, a false negative rate of 16.7 %, and a negative predictive value of 97.6 %. The sensitivity, specificity, false negative rate, and negative predictive value of END in detecting occult metastasis were 64.3 %, 100 %, 35.7 %, and 93.2 %, respectively. In comparison to END after propensity score matching, SLNB exhibited no significant difference in its effects on regional control (p = 0.519, HR: 1.05, 95 % CI: 0.52-1.93) and disease-specific survival (p = 0.634, HR: 1.22, 95 % CI: 0.53-1.99). Patients in SLNB group showed significantly higher mean scores of shoulder and taste domains at 3 months, 6 months, and 12 months postoperatively compared to those in END group.
SLNB could act as a viable alternative to END in cT1/2N0 maxillary squamous cell carcinoma with comparable prognosis and better quality of life.
评估 cT1/2N0 上颌鳞状细胞癌患者中前哨淋巴结活检（SLNB）与选择性颈部清扫术（END）相比的肿瘤安全性和生活质量。
这是一项回顾性分析连续治疗的患者的研究，这些患者接受了 SLNB 或 END，数据是前瞻性收集的。我们通过 Cox 模型分析了不同颈部手术对区域控制和疾病特异性生存的影响。两组患者均完成了华盛顿大学生活质量问卷。
共纳入 130 例患者，其中 47 例接受 SLNB。所有病例均能识别出前哨淋巴结，其中 5 例为阳性，灵敏度为 83.3%，特异性为 100%，假阴性率为 16.7%，阴性预测值为 97.6%。在检测隐匿性转移方面，END 的灵敏度、特异性、假阴性率和阴性预测值分别为 64.3%、100%、35.7%和 93.2%。与倾向评分匹配后的 END 相比，SLNB 在区域控制（p=0.519，HR：1.05，95%CI：0.52-1.93）和疾病特异性生存（p=0.634，HR：1.22，95%CI：0.53-1.99）方面无显著差异。与 END 组相比，SLNB 组患者在术后 3 个月、6 个月和 12 个月时肩部和味觉领域的平均评分显著更高。
SLNB 可作为 cT1/2N0 上颌鳞状细胞癌的一种可行替代选择，具有相似的预后和更好的生活质量。
