Source: www.medpagetoday.com Author: Michael Smith, North American Correspondent, MedPage Today In early oral squamous cell carcinoma, a sentinel node biopsy correctly predicted an absence of lymphatic metastasis in all but 4% of patients, researchers said. For T1 and T2 lesions that were clinically node-negative, the procedure -- combined with additional sectioning and immunohistochemistry -- yielded a negative predictive value of 96%, according to Francisco Civantos Jr., MD, of the University of Miami, and colleagues. For T1 lesions, the value was 100%, while for T2 cancers it was 94%, the researchers reported online in the Journal of Clinical Oncology. The finding may position the procedure as an intermediate option between watchful waiting and selective neck dissection, the researchers said, asserting that it's now "reasonable" to conduct a head-to-head trial of sentinel node biopsy and neck dissection. The procedure has significantly increased the sensitivity for detecting lymphatic metastasis in melanoma and breast cancer patients, Civantos and colleagues noted. But in oral cancer, many surgeons prefer a completion neck dissection, they added, despite the "measurable morbidity" that's associated with the procedure. On the other hand, because of that morbidity, other specialists prefer watchful waiting and elective neck irradiation. To investigate the issue, Civantos and colleagues conducted a multicenter trial in which patients with early invasive oral cancers were treated with both procedures -- a sentinel node biopsy, followed by completion selective neck dissection. The primary goal was to see if a negative hematoxylin and eosin finding on the sentinel node biopsy accurately predicted [...]