Lymphoscintigraphy in oral squamous cell carcinoma sentinel node biopsy and its role in the surgical planning.

AIM: The purpose of this study was to analyze the influence of different lymphatic pathways on surgical planning and the reliability of sentinel lymph node (SLN) biopsy to predict regional recurrence in patients with clinically N0 oral squamous cell carcinoma (OSCC). METHODS: Twenty-five patients with cT1/T2 N0 OSCC underwent a lymphoscintigraphy and an SLN biopsy. Elective neck dissection was performed at the validation stage and in patients with metastatic SLN. Scintigraphic and surgical SLN detection, pathologic status of SLN and of elective neck dissection, and regional recurrence in patients with negative SLN (pN0(sn)) were all analyzed. RESULTS: Scintigraphic and surgical detection were 96% and 100%, respectively, with 68% of negative SLN. Lymphoscintigraphy modified surgery in 32% of patients. In pN0(sn) patients, the free-of-disease survival rate was 88%. CONCLUSIONS: These results support the reliability of sentinel node biopsy in OSCC. Presurgical lymphoscintigraphy is essential, because it can modify the surgical procedure.