Sentinel lymph node biopsy in oral squamous cell carcinoma - Ensuing from elective to selective

The status of lymph node involvement holds prime importance in the prognosis and therapy of oral squamous cell carcinoma (OSCC). Clinically and radiologically negative neck lymph nodes in early OSCC frequently create difficulty in predicting prognosis and defining treatment, owing to the chances of occult metastasis. In case of the lymphatic spread of the carcinoma, lymphatic drain will first pass through sentinel lymph nodes. The sentinel lymph node (SLN) is defined as the lymph node on the direct drainage pathway from the primary tumor. Sentinel lymph node biopsy (SLNB) is a minimally invasive technique and can be used for staging of cN0 neck in early OSCC. It helps to identify “skip” metastases and unpredictable lymphatic drainage patterns. Elective lymph node dissection (ELND) is frequently used as an adjunctive therapy to improve the cure rates of patients with cN0 OSCC and has been applied for staging as well, but it holds a greater risk of morbidity as compared to SLNB. Sentinel lymph node biopsy (SLNB) poses to be a feasible, safe and reliable prognostic tool for cN0 OSCC. Here’s an attempt to understand the validity of SLNB over ELND