Sentinel lymph node biopsy in clinically N0 laryngeal cancer: validation and application

Purpose or Objective: Cervical lymph node dissection for laryngeal cancer patients without clinical and radiologic evidence of regional metastasis (N0) is controversial. Aim of our study was to validate sentinel lymph node biopsy (SLNB) procedure and evaluate its applicability in early T1-T2 N0 laryngeal SCC. Material and Methods: A prospective study conducted at the Lithuanian University of Health Sciences Hospital, with the permission of institutional review board. Inclusion period 2010-2013y. Patients with histologically confirmed laryngeal SCC T-2, N0 were involved. Two phase design: validation phase - SLNB and selective neck dissection (SND) were performed simultaneously; application phase - SND was performed according to SLNB outcome. The end points for SLNB validation phase: sensitivity, specificity, negative-predictive value (NPV). Patients from both phases were followed-up after treatment and compared for recurrence-free survival (RFS). Sentinel lymph nodes (SLN) were located by 99mTc lymphoscintigraphy and gamma probe. Pathological evaluation included hematoxylin and eosin staining and immunohistochemistry. Statistical analysis was performed by using SPSS® v20.0, Clinical Calculator 1, ©Richard Lowry 2001-2015. The Pearson X2 was used for categorical data. Significant p-value