Annals of Surgical Oncology

, Volume 16, Issue 2, pp 233–239 | Cite as

Positive Sentinel Lymph Nodes are a Negative Prognostic Factor for Survival in T1-2 Oral/Oropharyngeal Cancer—A Long-Term Study on 103 Patients

  • Adorján F. Kovács
  • Ulrich Stefenelli
  • Oliver Seitz
  • Marcus Middendorp
  • Jürgen Diener
  • Robert Sader
  • Frank Grünwald
Head and Neck Oncology



To evaluate prognostic value of sentinel node biopsy (SNB) in oral/oropharyngeal squamous cell cancer (OOSCC) concerning overall/disease-free survival.


One hundred three consecutive patients with T1-2N0 OOSCC were consecutively recruited for SNB as single invasive staging method for the neck. Two hundred seventy-three sentinel nodes (SNs) were removed (mean, 2.65 per patient). Nine patients had 10 positive SNs (upstaging rate, 8.7%) found in levels I to III, leading to a therapeutic neck dissection.


Mean observation time of all patients was 6.7 years; mean survival time of patients with negative or positive SNs was 6.9 and 3.7 years, respectively. There has been no false-negative result of SNB to date becoming manifest in ipsilateral node metastasis during follow-up. Five-year overall/disease-free survival of all patients was 82%/72%, respectively. The same parameters for the patients with negative SNs were 85%/74%, for those with positive SNs 38%/47%, respectively (statistically significant). There has been a higher statistical risk for locoregional recurrence for patients with positive SNs. Rates of metachronous second primary tumors developing during follow-up were 10.6% (negative SNs) and 44.4% (positive SNs).


SNB was a valuable diagnostic method in patients with T1-2N0 OOSCC avoiding elective neck dissections. Patients with positive SNs had statistically significantly higher rates of locoregional recurrences, second primary tumors, tumor-related deaths, and a worse overall/disease-free survival. To date, no therapeutic consequences in case of a positive SN beyond execution of modified radical neck dissection (to remove other positive nodes) and closer attention during follow-up can be concluded from this study.


Positron Emission Tomography Sentinel Node Sentinel Node Biopsy Neck Dissection Positive Sentinel Node 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Society of Surgical Oncology 2008

Authors and Affiliations

  • Adorján F. Kovács
    • 1
  • Ulrich Stefenelli
    • 2
  • Oliver Seitz
    • 1
  • Marcus Middendorp
    • 3
  • Jürgen Diener
    • 3
  • Robert Sader
    • 1
  • Frank Grünwald
    • 3
  1. 1.Department of Oral and Cranio-Maxillofacial Plastic SurgeryJohann Wolfgang Goethe University Medical SchoolFrankfurt am MainGermany
  2. 2.Ulrich Stefenelli, Services-in-StatisticsWürzburgGermany
  3. 3.Department of Nuclear MedicineJohann Wolfgang Goethe University Medical SchoolFrankfurt am MainGermany

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