Abstract
Aims: We compared the prognostic utility of sentinel node
biopsy (SNB) and elective neck dissection (END) in patients with early
(T1–2) oral cavity squamous cell carcinoma (OSCC) and clinically N0
necks.
Methods: We searched the PubMed, SCOPUS, Embase, Web of
Science, and Cochrane library databases up to March 2022. The hazard
ratios (HRs), Kaplan–Meier curves, p-values, and survival outcomes were
extracted, along with all study characteristics. Methodological quality
was assessed using the Cochrane Risk of Bias tool.
Results: Twelve studies involving 10,583 patients were finally
included. We found no significant differences in overall survival (OS)
(HR = 1.1226; 95% confidence interval [CI]: 0.9263; 1.3604),
disease-free survival (DFS) (HR = 1.0797; 95% CI: 0.8765; 1.3300) or
disease-specific survival (DSS) (HR = 0.8652; 95% CI: 0.6531; 1.1462)
between the two groups. Heterogeneity was not detected in pooled OS,
DFS, and DSS analyses (all I2 < 50). In
subgroup analyses by follow-up period (3, 5, and 10 years), SNB and END
had similar prognostic value.
Conclusions: We found no significant difference in OS, DFS, or
DSS between patients with early OSCC and clinical N0 necks evaluated via
SNB and END, suggesting that SNB might be a valuable alternative to END
for the management of early stage clinically node-negative OSCC.
Keywords: elective neck dissection, sentinel node biopsy, oral
cancer, survival, meta-analysis