Abstract：
OBJECTIVE: To evaluate the oncologic safety and quality of life associated with the use of sentinel lymph node biopsy (SLNB) as compared to elective neck dissection (END) in patients with cT1/2N0 maxillary squamous cell carcinoma.
METHODS: This study constituted a retrospective analysis of consecutively treated patients who underwent SLNB or END, with data collected prospectively. We analyzed the impact of the different neck procedures on regional control and disease-specific survival via the Cox model. Patients in both groups completed the University of Washington Quality of Life questionnaire.
RESULTS: We included a total of 130 patients, with 47 receiving SLNB. In all cases, the sentinel lymph node could be identified, and of these, 5 had a positive result, yielding a sensitivity of 83.3 %, a specificity of 100 %, a false negative rate of 16.7 %, and a negative predictive value of 97.6 %. The sensitivity, specificity, false negative rate, and negative predictive value of END in detecting occult metastasis were 64.3 %, 100 %, 35.7 %, and 93.2 %, respectively. In comparison to END after propensity score matching, SLNB exhibited no significant difference in its effects on regional control (p = 0.519, HR: 1.05, 95 % CI: 0.52-1.93) and disease-specific survival (p = 0.634, HR: 1.22, 95 % CI: 0.53-1.99). Patients in SLNB group showed significantly higher mean scores of shoulder and taste domains at 3 months, 6 months, and 12 months postoperatively compared to those in END group.
CONCLUSIONS: SLNB could act as a viable alternative to END in cT1/2N0 maxillary squamous cell carcinoma with comparable prognosis and better quality of life.
METHODS: This study constituted a retrospective analysis of consecutively treated patients who underwent SLNB or END, with data collected prospectively. We analyzed the impact of the different neck procedures on regional control and disease-specific survival via the Cox model. Patients in both groups completed the University of Washington Quality of Life questionnaire.
RESULTS: We included a total of 130 patients, with 47 receiving SLNB. In all cases, the sentinel lymph node could be identified, and of these, 5 had a positive result, yielding a sensitivity of 83.3 %, a specificity of 100 %, a false negative rate of 16.7 %, and a negative predictive value of 97.6 %. The sensitivity, specificity, false negative rate, and negative predictive value of END in detecting occult metastasis were 64.3 %, 100 %, 35.7 %, and 93.2 %, respectively. In comparison to END after propensity score matching, SLNB exhibited no significant difference in its effects on regional control (p = 0.519, HR: 1.05, 95 % CI: 0.52-1.93) and disease-specific survival (p = 0.634, HR: 1.22, 95 % CI: 0.53-1.99). Patients in SLNB group showed significantly higher mean scores of shoulder and taste domains at 3 months, 6 months, and 12 months postoperatively compared to those in END group.
CONCLUSIONS: SLNB could act as a viable alternative to END in cT1/2N0 maxillary squamous cell carcinoma with comparable prognosis and better quality of life.
摘要：
目的：评估cT1/2N0上颌鳞状细胞癌患者前哨淋巴结活检（SLNB）与选择性颈淋巴结清扫术（END）的肿瘤学安全性和生活质量。
方法：本研究对连续接受SLNB或END治疗的患者进行回顾性分析，前瞻性收集的数据。我们通过Cox模型分析了不同颈部手术对区域控制和疾病特异性生存的影响。两组患者均完成华盛顿大学生活质量问卷。
结果：我们共纳入130名患者，47接收SLNB。在所有情况下,前哨淋巴结可以被识别,其中，5有积极的结果，灵敏度为83.3%，100%的特异性，假阴性率为16.7%，阴性预测值为97.6%。敏感性,特异性，假阴性率，END检测隐匿性转移的阴性预测值为64.3%，100%,35.7%,和93.2％，分别。与倾向得分匹配后的END相比，SLNB对区域控制（p=0.519，HR：1.05，95％CI：0.52-1.93）和疾病特异性生存率（p=0.634，HR：1.22，95％CI：0.53-1.99）的影响没有显着差异。SLNB组患者在3个月时表现出明显较高的肩部和味觉领域的平均得分，6个月,与END组相比，术后12个月。
结论：SLNB在cT1/2N0上颌鳞状细胞癌中可以作为END的可行替代方案，具有相当的预后和更好的生活质量。
方法：本研究对连续接受SLNB或END治疗的患者进行回顾性分析，前瞻性收集的数据。我们通过Cox模型分析了不同颈部手术对区域控制和疾病特异性生存的影响。两组患者均完成华盛顿大学生活质量问卷。
结果：我们共纳入130名患者，47接收SLNB。在所有情况下,前哨淋巴结可以被识别,其中，5有积极的结果，灵敏度为83.3%，100%的特异性，假阴性率为16.7%，阴性预测值为97.6%。敏感性,特异性，假阴性率，END检测隐匿性转移的阴性预测值为64.3%，100%,35.7%,和93.2％，分别。与倾向得分匹配后的END相比，SLNB对区域控制（p=0.519，HR：1.05，95％CI：0.52-1.93）和疾病特异性生存率（p=0.634，HR：1.22，95％CI：0.53-1.99）的影响没有显着差异。SLNB组患者在3个月时表现出明显较高的肩部和味觉领域的平均得分，6个月,与END组相比，术后12个月。
结论：SLNB在cT1/2N0上颌鳞状细胞癌中可以作为END的可行替代方案，具有相当的预后和更好的生活质量。
