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Meta-Analysis
. 2013 Jul;270(7):2115-22.
doi: 10.1007/s00405-012-2320-0. Epub 2012 Dec 22.

Diagnostic value of sentinel lymph node biopsy in head and neck cancer: a meta-analysis

C F Thompson  1 , M A St John, G Lawson, T Grogan, D Elashoff, A H Mendelsohn
Affiliations
Meta-Analysis

Diagnostic value of sentinel lymph node biopsy in head and neck cancer: a meta-analysis

C F Thompson et al. Eur Arch Otorhinolaryngol. 2013 Jul.

Abstract

This study aimed to evaluate the diagnostic reliability of sentinel lymph node biopsy in patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx by reviewing the published literature. A systematic literature review was performed using MEDLINE from 1970 to 2011. With Boolean search strings, search terms included sentinel node, supraglottic, supraglottis, tongue, head and neck, oral, pharynx, laryngeal, and larynx. Additional studies were identified through article references. Duplicate data and articles were excluded based on treating institution and study inclusion time period. Additional studies were excluded if the head and neck subsite or tumor stage was not specifically identified or if the sentinel lymph node biopsy occurred in previously treated necks. All patients had sentinel lymph node biopsy performed followed by a concurrent neck dissection. Twenty-six studies met our inclusion criteria (n = 766 patients). The pooled sensitivity and negative predictive value of SLNB for all head and neck tumors was 95 % (95 % CI 91-99 %) and 96 % (95 %CI 94-99 %), respectively. The overall sensitivity and negative predictive value of SLNB in the subset of oral cavity tumors (n = 631) was 94 % (95 % CI 89-98 %) and 96 % (95 % CI 93-99 %), respectively. One-hundred percent of oropharyngeal (n = 72), hypopharyngeal (n = 5), and laryngeal (n = 58) tumor sentinel lymph biopsy results correlated with subsequent neck dissections giving a negative predictive value of 100 %, showing that, sentinel lymph node biopsy is a valid diagnostic technique to correctly stage regional metastases in patients with head and neck squamous cell carcinoma.

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Figures

Fig. 1
Fig. 1
Forest plot of the sensitivity for all head and neck subsites
Fig. 2
Fig. 2
Forest plot of the negative predictive value for all head and neck subsites
Fig. 3
Fig. 3
Forest plot of the sensitivity for oral cavity subsite
Fig. 4
Fig. 4
Forest plot of the negative predictive value for oral cavity subsite
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