A diagnostic value of sentinel node biopsy in a group of head and neck squamous cell carcinoma patients

Author: Jorūnė Šuipytė Title: A diagnostic value of sentinel node biopsy in a group of head and neck squamous cell carcinoma patients. Aim: To evaluate and compare the efectiveness and safetiness of sentinel lymph node biopsy in a group of laryngeal squamous cell carcinoma validation phase patients. Objectives: 1. To evaluate time until progression in a group of laryngeal squamous cell carcinoma validation phase patients. 2. To identify and evaluate identification value of SPECT-CT and Gamma detector. 3. To identify the frequency of sentinel node localization. 4. To evaluate the sensivity, specifity, negative and positive predictive value of sentinel lymph node biopsy in a group of laryngeal squamous cell carcinoma validation phase patients. Methods: A prospective cohort study was performed. All patients were monitored for the progression of disease until February 15th, 2017. The statistical data analysis was performed using SPSS 22.0 and MS Excel 2013 programs. Clinical Calculator 1, ©Richard Lowry 2001-2016 was used to measure sensitivity and specifity of the procedure (significance level p≤0,05). Participants: we involved 58 patients, who were diagnozed and treated for early laryngeal squamous cell carcinoma without dissemination to regional neck lymph nodes (cT1-2 N0) from 2011m. to 2016 m. We excluded those, who before had surgical or radiation treatment in neck region; who have tumors, which are complicated to evaluate during laringoscopy; who are diagnosed with other type of cancer or suffer from mental disorders; who will not be able to follow the schedule of the protocol. Results: Sentinel lymphnode biopsy sensitivity - 75.00 %. (19.41 - 99.37 %. 95% CI), specifity - 95.83 % (78.88 - 99.89 proc. 95% CI); recurrence – free survival time between validation (50,9 months) and application (63,34 months) groups was not statistically significant (p=0,088), Mean – 57,12 months. Conclusions: 1. There was no statistical significant difference until time til progression between validation and application phase groups (50,9 and 63,34 months, p=0,088). 2. No statistically significant difference found in number of detected sentinel lymph nodes, between SPECT/CT and Gama probe techniques (p=0,2). 3. Sentinel nodes detected in level II (31proc.), III (46,6 proc.) and same side lymphnodes. 4. Biopsy sensitivity is 75.00 %, specifity - 95.83 %, negative predictive value - 95.83 %, positive predictive value - 75.00 %