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Figure 1: Literature search flow chart and selected studies form the literature according to inclusion criteria. SNB: sentinel node biopsy; OSCC: oral
squamous cell cancer

cancer. The presence of a single positive lymph node can patients has encouraged the application of sentinel node
reduce disease free survival at 5 years by 50%. In order biopsy (SNB). SNB entails identifying and harvesting the
to perform an adequate treatment of the neck, a correct initial node, to which the primary tumor drains, while
diagnosis and staging are crucial for determining prognosis. [2] limiting dissection and harm to vital structures. The
advantages of implementing SNB instead of ND include
OSCC frequently metastasizes to the cervical nodal basins, decreased morbidity, operating room time, and length of
yet clinical staging with physical exam and imaging postoperative stay. [9]
modalities [positron emission tomography-computed
tomography (CT), CT scan, magnetic resonance imaging SNB is a radio-isotopic technique that included: a
or ultrasound] usually cannot detect metastases less than peritumoral injection of adequate radiotracer that will be
8 to 10 mm in size. [3,4] Thus, for the last few years, the trapped by the regional lymphatic chains and echelons, an
conventional procedure for the clinically node negative imaging technique capable depicting these, a radio guided
(N0) patient has been neck dissection (ND), which leads to surgical procedure for removing sentinel node (SN) and
increased loco-regional control and regional recurrence- a pathological study of the node that allows to know the
free survival. However, ND is an aggressive procedure that status of the node. [10]
represents overtreatment for approximately 70% of cN0
patients who are found to have a histological negative neck SNB as a staging procedure and decision tool to establish
for metastases. [5-7] ND is traditionally recommended when whether surgical treatment of the lymphatic area is to
the tumor size and subsite confer at least a 15-20% risk of be performed or not, is now recognized as the gold
[8]
lymphatic spread. Nevertheless, in OSCC tumors that have standard in melanoma and breast cancer. [10,11] Although the
20% rate of nodal metastasis, the vast majority of these methodology of sentinel lymphatic node biopsy (SLNB) in
patients will undergo ND with no evidence of lymph node OSCC has been well known for more than 10 years and
metastasis. [1] many prospective studies with a significant number of
patients have been published, it has not been accepted
A conservative trend in the treatment of OSCC N0 worldwide, where it is still considered investigational. [2]
Plast Aesthet Res || Volume 3 || May 25, 2016 143