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The Second International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer

¹ Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Frauenklinikstrasse 24, CH-8091 Zurich, Switzerland
² Department of Pathology, University Hospital, Zurich, Switzerland
³ Plastic Surgery Unit, Canniesburn Hospital, Glasgow, United Kingdom
⁴ Division of Nuclear Medicine, University Hospital, Zurich, Switzerland
⁵ Oral Pathology Unit, Glasgow Dental Hospital and School, Glasgow, United Kingdom
⁶ Institute of Pathology, University of Leipzig, Leipzig, Germany

Correspondence: Address correspondence and reprint requests to: Sandro J. Stoeckli, MD; E-mail: sandro.stoeckli{at}usz.ch.

Background: The Second International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer was hosted by the Department of Otorhinolaryngology, Head and Neck Surgery of the University Hospital in Zurich, Switzerland, from September 12 to 13, 2003. The aims of this conference were to present the results of validation studies and to achieve a consensus on methodological requirements.

Methods: More than 80 delegates from 20 countries attended the conference. The presented validation studies were summarized and compared with the literature. Consensus was achieved concerning requirements for lymphatic mapping and histopathologic work-up.

Results: Twenty centers presented results on 379 patients with cN0 disease. Sentinel nodes were identified in 366 (97%) of 379. Of these 366, 103 (29%) were positive for occult metastasis, and 263 (71%) were negative. Of those 263 patients, 11 patients (4%) showed nodal disease not revealed by the sentinel lymph node biopsy (SNB). The negative predictive value of a negative sentinel node for the remaining neck was 96%. The consensus conference resulted in the use of a radiotracer, lymphoscintigraphy, and a handheld gamma probe for lymphatic mapping as minimal requirements. The use of conventional hematoxylin and eosin staining and immunohistochemistry for cytokeratin is mandatory. Step-sectioning of the entire node at intervals of 150 µm is recommended.

Conclusions: The conference attracted delegates from all over the world, thus underscoring the high interest in the topic. With regard to the presented data and the data from the literature, SNB for early oral and oropharyngeal cancer is sufficiently validated. The consensus conference resulted in the definition of minimal methodological requirements for accurate SNB.

Key Words: Sentinel node biopsy • Elective neck dissection • Micrometastasis • Oral carcinoma • Head and neck carcinoma

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