Characteristics of Patients with Upstaging by Sentinel Lymph Node Biopsy of the N0 Neck in Head and Neck Cancer

Introduction: To investigate the possible role of sentinel lymph node biopsy (SLNB) to upstage the N0 neck in patients with oral and oropharyngeal squamous cell carcinoma. Methods: Patients with T1-T2 oral and oropharyngeal squamous cell carcinoma accessible to injection and staged N0 into the neck by palaption and CTscan were enrolled in the study. All patients underwent regular follow-up to identify possible recurrence. Results: A sentine lymph node biopsy was performed by 21 consecutive patients. 4 of the 21 patients were upstaged by SNLB. There was a mean follow-up of 31 months. Two patients developed subsequent disease after having been staging by SLNB, respectively negative in one case and positive in the other case. Tumor site, the staging of the primary tumor, presence of ulceration, tumor thickness were the same in the upstaged initially N0 patients. Conclusions: Sentinel lymph node biopsy can be used to upstage the N0 neck patients in perhaps well defined patients.