ArticleIndian journal of surgical oncology2024
Single-Tracer Methylene Blue-Guided Sentinel Lymph Node Biopsy in Early-Stage Squamous Cell Carcinoma of the Buccal Mucosa: A Prospective Study.
Article in Indian journal of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Subsite and tumor stage-related heterogeneity in studies on optical tracer-guided sentinel lymph node biopsy (SLNB) in oral squamous cell carcinoma (SCC) has led to inconsistent results, limiting the applicability and wider adoption of this technique. Methodology: This single-center, prospective validation study conducted in January and February 2022, included 29 consecutive patients with early-stage, node-negative SCC of the buccal mucosa undergoing methylene blue-guided SLNB followed by modified radical neck dissection (considered the reference standard) to determine the identification rate and test validity of SLNB, and secondarily, the clinicopathological factors associated with node-positivity using binary logistic regression. Results: SLN identification rate with methylene blue was 93.1% with 66 SLNs retrieved in 27 patients, at a median 2 (IQR 2-3) nodes per procedure. Additionally, 644 nodes were grossed in the neck dissection specimens of 29 patients (median yield 24; IQR 17.5-26 per procedure). Overall accuracy of SLNB was 96.3% (95%CI 81.03-99.91%), with sensitivity and negative predictive value of 83.3% (95%CI 35.88-99.58%) and 95.5% (95%CI 77.16-99.88%), respectively. The only factor independently predictive of occult nodal involvement was pathological depth of infiltration (hazard ratio 3.312; 95%CI 1.040-10.546, Conclusion: Methylene blue-guided SLNB may be considered a viable alternative to evaluate the neck in early-stage buccal mucosal SCC with acceptable test validity and reliability. [Registered with the Clinical Trials Registry of India (CTRI/2022/01/039523 dated 18th January 2022)].
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