Biopsy of the sentinel lymph nodes in early oral cancer: literature review
- Authors: Osokin S.V.1, Musin S.I.1, Sharafutdinova N.A.1, Menshikov K.V.1,2, Ilyin V.V.1, Baymuratov T.R.1, Shafikova M.R.1
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Affiliations:
- Republican Clinical Oncological Dispensary, Ministry of Health of the Republic of Bashkortostan
- Bashkir State Medical University, Ministry of Health of Russia
- Issue: Vol 15, No 4 (2025)
- Pages: 108-115
- Section: REVIEWS
- Published: 18.03.2026
- URL: https://ogsh.abvpress.ru/jour/article/view/1064
- DOI: https://doi.org/10.17650/2222-1468-2025-15-4-108-115
- ID: 1064
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Full Text
Abstract
Biopsy of the sentinel lymph nodes is a modern technique of surgical staging of head and neck tumors. It allows to determine advisability of cervical lymph node dissection in patients with early-stage oral cancer.
The article presents a literature review on the history, methodology, and clinical efficacy of sentinel lymph node biopsy. It is shown that technological development and implementation of new indicators increase method efficacy, minimizing unnecessary surgical interventions and decreasing the risk of complications.
About the authors
S. V. Osokin
Republican Clinical Oncological Dispensary, Ministry of Health of the Republic of Bashkortostan
Author for correspondence.
Email: osokinsv@yandex.ru
ORCID iD: 0000-0003-4639-962X
Russian Federation, 73 / 1 Octyabrya Prospekt, Ufa 450054
Sh. I. Musin
Republican Clinical Oncological Dispensary, Ministry of Health of the Republic of Bashkortostan
Email: osokinsv@yandex.ru
ORCID iD: 0000-0003-1185-977X
Russian Federation, 73 / 1 Octyabrya Prospekt, Ufa 450054
N. A. Sharafutdinova
Republican Clinical Oncological Dispensary, Ministry of Health of the Republic of Bashkortostan
Email: osokinsv@yandex.ru
ORCID iD: 0009-0007-4933-7236
Russian Federation, 73 / 1 Octyabrya Prospekt, Ufa 450054
K. V. Menshikov
Republican Clinical Oncological Dispensary, Ministry of Health of the Republic of Bashkortostan; Bashkir State Medical University, Ministry of Health of Russia
Email: osokinsv@yandex.ru
ORCID iD: 0000-0003-3734-2779
Russian Federation, 73 / 1 Octyabrya Prospekt, Ufa 450054; 3 Leninа St., Ufa 450008
V. V. Ilyin
Republican Clinical Oncological Dispensary, Ministry of Health of the Republic of Bashkortostan
Email: osokinsv@yandex.ru
ORCID iD: 0000-0003-1334-5887
Russian Federation, 73 / 1 Octyabrya Prospekt, Ufa 450054
T. R. Baymuratov
Republican Clinical Oncological Dispensary, Ministry of Health of the Republic of Bashkortostan
Email: osokinsv@yandex.ru
ORCID iD: 0009-0005-4980-1380
Russian Federation, 73 / 1 Octyabrya Prospekt, Ufa 450054
M. R. Shafikova
Republican Clinical Oncological Dispensary, Ministry of Health of the Republic of Bashkortostan
Email: osokinsv@yandex.ru
ORCID iD: 0009-0009-7516-0870
Russian Federation, 73 / 1 Octyabrya Prospekt, Ufa 450054
References
- The state of oncological care for the Russian population in 2023. Ed. by A.D. Kaprin, V.V. Starinsky, A.O. Shakhzadova. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMITS radiologii” Minzdrava Rossii, 2024. 262 p. (In Russ.).
- Shah J.P., Candela F.C., A.K. Poddar The patterns of cervical lymph node metastases from squamous carcinoma of the oral cavity. Cancer 1990;66(1):109–13. doi: 10.1002/1097-0142(19900701)66:1<109::aid-cncr2820660120>3.0.co;2-a
- Chaudhary N., Verma R.K., Agarwal U. et al. Incidence of occult metastasis in clinically N0 oral tongue squamous cell carcinoma and its association with tumor staging, thickness, and differentiation. J Head Neck Physicians Surg 2017;5(2):75–8.
- Shah J.P., Gil Z. Current concepts in management of oral cancer surgery. Oral Oncol 2009;45(4–5):394–401. doi: 10.1016/j.oraloncology.2008.05.017
- Hakeem A.H., Pradhan S.A., Tubachi J., Kannan R. Outcome of per oral wide excision of T1-2 N0 localized squamous cell cancer of the buccal mucosa-analysis of 156 cases. Laryngoscope 2013;123(1):177–80. doi: 10.1002/lary.23707
- Koerdt S., Röckl J., Rommel N. et al. Lymph node management in the treatmentof oral cancer: analysis of a standardized approach. J Craniomaxillofac Surg 2016;44(10):1737–42. doi: 10.1016/j.jcms.2016.08.002
- Imai T., Satoh I., Matsumoto K. et al. Retrospective observational study of occult cervical lymph-node metastasis in T1N0 tongue cancer. Jpn J Clin Oncol 2017;47(2):130–6. doi: 10.1093/jjco/hyw172
- Morand G.B., Ikenberg K., Vital D.G. et al. Preoperative assessment of CD44-mediated depth of invasion as predictor of occult metastases in early oral squamous cell carcinoma. Head Neck 2019;41(4):950–8. doi: 10.1002/hed.25532
- Weiss M.H., Harrison L.B., Isaacs R.S. Use of decision analysis in planning a management strategy for the stage N0 neck. Arch Otolaryngol Head Neck Surg 1994;120(7):699–702. doi: 10.1001/archotol.1994.01880310005001
- Okura M., Aikawa T., Sawai N.Y. et al. Decision analysis and treatment threshold in a management for the N0 neck of the oral cavity carcinoma. Oral Oncol 2009;45(10):908–11. doi: 10.1016/j.oraloncology.2009.03.013
- Dijkstra P.U., van Wilgen P.C., Buijs R.P. et al. Incidence of shoulder pain after neck dissection: a clinical explorative study for risk factors. Head Neck 2001;23(11):947–53. doi: 10.1002/hed.1137
- Wushou A., Wang M., Yibulayin F. et al. Patients with cT1N0M0 oral squamous cell carcinoma benefit from elective neck dissection: a SEER-based study. J Natl Compr Canc Netw 2021;19(4):385–92. doi: 10.6004/jnccn.2020.7632
- Bernier J., Rossier C., Horiot J.C. Recent advances in regional treatment of breast carcinoma. Crit Rev Oncol Hematol 2016;99:107–14. doi: 10.1016/j.critrevonc.2015.12.003
- Cabanas R.M. An approach for the treatment of penile carcinoma. Cancer 1977;39(2):456–66. doi: 10.1002/1097-0142(197702)39:2<456::aid-cncr2820390214>3.0.co;2-i
- Morton D.L., Thompson J.F., Cochran A.J. et al. Final trial report of sentinel-node biopsy versus nodal observation in melanoma. N Engl J Med 2014;370(7):599–609. doi: 10.1056/NEJMoa1310460
- Ross G.L., Shoaib T., Soutar D.S. et al. The first international conference on sentinel node biopsy in mucosal head and neck cancer and adoption of a multicenter trial protocol. Ann Surg Oncol 2002;9(4):406–10. doi: 10.1007/BF02573877
- Stoeckli S.J., Pfaltz M., Ross G.L. et al.The second international conference on sentinel node biopsy in mucosal head and neck cancer. Ann Surg Oncol 2005;12(11):919–24. doi: 10.1245/ASO.2005.11.024
- Alkureishi L.W., Burak Z., Alvarez J.A. et al. Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma. Ann Surg Oncol 2009;16(11):3190–210. doi: 10.1245/s10434-009-0726-8
- Civantos F.J., Zitsch R.P., Schuller D.E. et al. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1–T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol 2010;28(8):1395–400. doi: 10.1200/JCO.2008.20.8777
- Govers T.M., Hannink G., Merkx M.A. et al. Sentinel node biopsy for squamous cell carcinoma of the oral cavity and oropharynx: a diagnostic meta-analysis. Oral Oncol 2013;49(8):726–32. doi: 10.1016/j.oraloncology.2013.04.006
- Liu M., Wang S.J., Yang X. Peng H. Diagnostic efficacy of sentinel lymph node biopsy in early oral squamous cell carcinoma: a meta-analysis of 66 studies. PLoS One 2017;12(1):e0170322. doi: 10.1371/journal.pone.0170322
- Hingsammer L., Seier T., Zweifel D. et al. Sentinel lymph node biopsy for early stage tongue cancer-a 14-year single-centre experience. Int J Oral Maxillofac Surg 2019;48(4):437–42. doi: 10.1016/j.ijom.2018.10.011
- Salzano G., Togo G., Maffia F. et al. Early-stage oral tongue squamous cell carcinoma and a positive sentinel lymph node biopsy: description of a prognostic correlation between pre-treatment inflammatory biomarkers, the depth of invasion and the worst pattern of invasion. J Pers Med 2022;12(11):1931. doi: 10.3390/jpm12111931
- Park W., Jin H., Heo Y. et al. Sentinel lymph node biopsy versus elective neck dissection: long-term oncologic outcomes in clinically node-negative tongue cancer. Clin Exp Otorhinolaryngol 2022;15(1):107–14. doi: 10.21053/ceo.2020.02411
- Cramer J.D., Sridharan S., Ferris R.L. Sentinel lymph node biopsy versus elective neckdissection for stage I to II oral cavity cancer. Laryngoscope 2019;129(1):162–9. doi: 10.1002/lary.27323. PMID: 30284248.
- Kim D.H., Kim Y., Kim S.W., Hwang S.H. Usefulness of sentinel lymph node biopsy for oral cancer: a systematic review and meta-analysis. Laryngoscope 2021;131(2):E459–65. doi: 10.1002/lary.28728
- Jang S.S., Davis M.E., Vera D.R. et al. Role of sentinel lymph node biopsy for oral squamous cell carcinoma: current evidence and future challenges. Head Neck 2023;45(1):251–65. doi: 10.1002/hed.27207
- Ross G.L., Soutar D.S., MacDonald D.G. et al. Sentinel node biopsy in head and neck cancer: preliminary results of a multi-center trial. Ann Surg Oncol 2004;11(7):690–6. DOI: 10.1245/ ASO.2004.09.001
- Gallegos-Hernández J.F., Hernández-Hernández D.M., Flores-Díaz R. et al. The number of sentinel nodes identified as prognostic factor in oral epidermoid cancer. Oral Oncol 2005;41(9):947–52. doi: 10.1016/j.oraloncology.2005.05.010
- Abdul-Razak M., Chung H., Wong E. et al. Sentinel lymph node biopsy for early oral cancers: Westmead Hospital experience. ANZ J Surg 2017;87(1–2):65–9. doi: 10.1111/ans.13853
- Schilling C., Stoeckli S.J., Haerle S.K. et al. Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer 2015;51(18):2777–84. doi: 10.1016/j.ejca.2015.08.023
- D’Cruz A.K., Vaish R., Kapre N. et al. Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med 2015;373(6):521–9. doi: 10.1056/NEJMoa1506007
- Den Toom I.J., van Schie A., van Weert S. et al. The added value of SPECT-CT for the identification of sentinel lymph nodesin early stage oral cancer. Eur Nucl Med Mol Imaging 2017;44(6): 998–1004. doi: 10.1007/s00259-017-3613-8
- Hutchison I.L., Ridout F., Cheung S.M.Y. et al. Nationwide randomised trial evaluating elective neck dissection for early stage oral cancer (SEND study) with meta-analysis and concurrent real-world cohort. Br J Cancer 2019;121(10):827–36. doi: 10.1038/s41416-019-0587-2
- Garrel R., Poissonnet G., Moyà Plana A. et al. Equivalence randomized trial to compare treatment on the basis of sentinel node biopsy versus neck node dissection in operable T1–T2N0 oral and oropharyngeal cancer. J Clin Oncol 2020;38(34):4010–8. doi: 10.1200/JCO.20.01661
- Saleem M.I., Peng T., Zhu D. et al. Sentinel lymph node biopsy versus elective node dissection in stage cT1–2N0 oral cavity cancer. Laryngoscope 2022;132(5):989–98. doi: 10.1002/lary.29895
- Hasegawa Y., Tsukahara K., Yoshimoto S. et al. Neck dissections based on sentinel lymph node navigation versus elective neck dissections in early oral cancers: a randomized, multicenter, and noninferiority trial. J Clin Oncol 2021;39(18):2025–36. doi: 10.1200/JCO.20.03637
- Gupta T., Maheshwari G., Kannan S. et al. Should sentinel lymph node biopsy be considered the new standard of care for early-stage clinically node-negative oral squamous cell carcinoma? J Clin Oncol 2022;40(15):1706–9. doi: 10.1200/JCO.21.02781
- Gupta T., Maheshwari G., Kannan S. et al. Systematic review and meta-analysis of randomized controlled trials comparing elective neck dissection versus sentinel lymph node biopsy in early-stage clinically node-negative oral and/or oropharyngeal squamous cell carcinoma: evidence-base for practice and implications for research. Oral Oncol 2022124:105642. doi: 10.1016/j.oraloncology.2021.10564
- Ionna F., Pavone E., Aversa C. et al. Sentinel lymph node biopsy (SLNB) for early-stage head and neck squamous-cell carcinoma of the tongue: twenty years of experience at I.N.T. “G.Pascale”. Cancers (Basel) 2024;16(6):1153. doi: 10.3390/cancers16061153
- Singh A., Roy S., Tuljapurkar V. et al. Critical review of the current evidence on sentinel node biopsy in oral cancer. Curr Oncol Rep 2022;24(6):783–91. doi: 10.1007/s11912-021-01171-2
- NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines(R)). Cancer of the Oral Cavity. Version 2.2025.
- Machiels J.P., René Leemans C., Golusinski W. et al. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS–ESMO–ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2020;31(11):1462–75. doi: 10.1016/j.annonc.2020.07.01
- SEOM clinical guidelines for the treatment of head and neck cancer. 2020.
- Fuereder T. ASCO virtual meeting 2020: highlights head and neck cancer. Memo 2021;14:62–5. doi: 10.1007/s12254-021-00679-4
- Koyfman S.A., Ismaila N., Crook D. et al. Management of the neck in squamous cell carcinoma of the oral cavity and oropharynx: ASCO clinical practice guideline. J Clin Oncol 2019;37(20):1753–74. doi: 10.1200/JCO.18.01921
- Homma A., Ando M., Hanai N. et al. Summary of Japanese clinical practice guidelines for head and neck cancer – 2022 update edited by the Japan society for head and neck cancer. Auris Nasus Larynx 2024;51(1):174–88. doi: 10.1016/j.anl.2023.07.003
- Malignant neoplasms of the oral cavity. Clinical recommendations of the Ministry of Health of Russia. 2024. (In Russ.).
- Chen Y., Xiao Q., Zou W. et al. Sentinel lymph node biopsy in oral cavity cancer using indocyanine green: A systematic review and meta-analysis. Clinics (Sao Paulo) 2021;76:e2573. doi: 10.6061/clinics/2021/e2573
- Luini A., Zurrida S., Galimberti V., Paganelli G. Radioguided surgery of occult breast lesions. Eur J Cancer 1998;34(1):204–5. doi: 10.1016/s0959-8049(97)00376-6
- Tu W., Denizot B. Synthesis of small-sized rhenium sulfide colloidal nanoparticles. J Colloid Interface Sci 2007;310(1):167–70. doi: 10.1016/j.jcis.2007.01.054
- Mariani G., Moresco L., Viale G. et al. Radioguided sentinel lymph node biopsy in breast cancer surgery. J Nucl Med 2001;42(8): 1198–215.
- Plut E.M., Hinkle G.H., Guo W., Lee R.J. Kit formulation for the preparation of radioactive blue liposomes for sentinel node lymphoscintigraphy. J Pharm Sci 2002;91(7):1717–32. doi: 10.1002/jps.10170
- Ermakov A.V., Shirokikh I.M., Zikiryakhodzhaev A.D. The technique of indirect lymphoscintigraphy with radioactive colloid Technetium 99mTc in identifing ways of lymphatic drainage and Sentinel lymph nodes biopsy in surgical treatment of patients with breast cancer and melanoma of the skin. Research’n Practical Medicine Journal 2016;Special Issue:72–3. (In Russ.).
- Doll C., Steffen C., Amthauer H. et al. sentinel lymph node biopsy in early stages of oral squamous cell carcinoma using the receptor-targeted radiotracer 99mTc-Tilmanocept. Diagnostics 2021;11(7):1231. doi: 10.3390/diagnostics11071231
- Kotov M.A., Radjabova Z.A.-G., Artemyev S.S. et al. Evolution of the concept of signal lymph node biopsy in head and neck cancer: from visualization of lymph vessels to signal nodes (literature review). Prakticheskaya onkologiya = Practical Oncology 2018;19(3):299–310. (In Russ.).
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