Sentinel lymph node biopsy in cT1-2N0 minor salivary gland cancer in oral cavity.

IF 3.4 2区 医学 Q2 ONCOLOGY BMC Cancer Pub Date : 2024-11-04 DOI:10.1186/s12885-024-13107-7
Peng Li, Xu Zhang, Qigen Fang, Wei Du
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Abstract

Objective: To evaluate the efficacy of sentinel lymph node biopsy (SLNB) in cT1/2N0 minor salivary gland cancer (mSGC) located within the oral cavity.

Methods: 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.

Results: 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.

Conclusion: 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.

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口腔 cT1-2N0 小涎腺癌的前哨淋巴结活检。
目的评估前哨淋巴结活检(SLNB)对口腔内 cT1/2N0 小涎腺癌(mSGC)的疗效:对确诊为 cT1/2N0 口腔 mSGC 的患者进行回顾性分析,根据颈部处理方法将患者分为两组。采用 Cox 模型评估了 SLNB 与观察对区域控制和总生存期的影响:研究共纳入 177 例患者,其中 53 例接受了 SLNB 治疗。所有患者至少有一个前哨淋巴结,其中大多数患者有两个前哨淋巴结。前哨淋巴结主要位于一级,其次是二级。有四名患者的前哨淋巴结呈阳性,他们的原发肿瘤都在舌头或口腔底部,并被列为 cT2 期。由此可见,SLNB 在预测隐匿性转移方面的敏感性和特异性均为 100%,假阴性率为 0%,阴性预测值为 100%。在区域控制方面,与观察相比,SLNB 的危险比为 0.90(95% 置信区间:0.64-0.96)。然而,与观察相比,SLNB并没有带来更好的总生存率:结论:对于 cT1/2N0 口腔 mSGC 患者,SLNB 被证明在技术上可行,在肿瘤学上安全。与观察相比,SLNB 可提高区域控制率,因此特别推荐用于来自舌部或口腔底部的 cT2 mSGC 病例。
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来源期刊
BMC Cancer
BMC Cancer 医学-肿瘤学
CiteScore
6.00
自引率
2.60%
发文量
1204
审稿时长
6.8 months
期刊介绍: BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.
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