Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, 450008, PR China.
BMC Cancer. 2024 Nov 4;24(1):1349. doi: 10.1186/s12885-024-13107-7.
To evaluate the efficacy of sentinel lymph node biopsy (SLNB) in cT1/2N0 minor salivary gland cancer (mSGC) located within the oral cavity.
A retrospective analysis was conducted on patients diagnosed with cT1/2N0 oral mSGC, who were categorized into two groups based on neck management approaches. The impact of SLNB versus observation on regional control and overall survival was assessed using a Cox model.
A total of 177 patients were included in the study, with 53 cases undergoing SLNB. All patients had at least one sentinel lymph node, with the majority having two sentinel lymph nodes. The sentinel lymph nodes were predominantly situated in level I, followed by level II. Four patients had positive sentinel lymph nodes, all of whom had primary tumors in the tongue or the floor of the mouth, and were classified as cT2 stage. This yielded a sensitivity and specificity of 100%, a false negative rate of 0%, and a negative predictive value of 100% for SLNB in predicting occult metastasis. In terms of regional control, SLNB exhibited a reduced hazard ratio of 0.90 (95% confidence interval: 0.64-0.96) compared to observation. However, SLNB did not confer a superior overall survival benefit compared to observation.
In patients with cT1/2N0 oral mSGC, SLNB proved to be both technically feasible and oncologically safe. When contrasted with observation, SLNB was associated with enhanced regional control, particularly recommending its use for cases of cT2 mSGC arising from the tongue or the floor of the mouth.
评估前哨淋巴结活检（SLNB）在口腔内 cT1/2N0 小唾液腺癌（mSGC）中的疗效。
对诊断为 cT1/2N0 口腔 mSGC 的患者进行回顾性分析，根据颈部管理方法将患者分为两组。使用 Cox 模型评估 SLNB 与观察对区域控制和总生存的影响。
共纳入 177 例患者，其中 53 例行 SLNB。所有患者均至少有一个前哨淋巴结，多数有两个前哨淋巴结。前哨淋巴结主要位于 I 水平，其次是 II 水平。4 例前哨淋巴结阳性，均为舌或口底原发肿瘤，均为 cT2 期。SLNB 预测隐匿性转移的灵敏度和特异性均为 100%，假阴性率为 0%，阴性预测值为 100%。在区域控制方面，SLNB 的风险比为 0.90（95%置信区间：0.64-0.96），低于观察组。然而，与观察相比，SLNB 并未带来更好的总生存获益。
在 cT1/2N0 口腔 mSGC 患者中，SLNB 既具有技术可行性，又具有肿瘤安全性。与观察相比，SLNB 与增强的区域控制相关，特别是对于舌或口底起源的 cT2 mSGC 病例，推荐使用 SLNB。
