Sentinel Node Biopsy in Larynx Cancer: 5 Years Follow-up

Background: The management of the clinically and radiologically negative neck in patients with early Head and Neck Squamous Cell Carcinoma (HNSCC) is still controversial. As ap- proximately 20 to 30% of these patients harbor occult disease in the neck, most of them have to undergo elective neck dissection with no great benefit to majority of them. Sentinel Lymph Node Biopsy (SLNB) is emerging as a potential method for staging of lymphatic metastasis in HNSCC. It has been demonstrated that the status of the sentinel node predicts the presence of metastasis in the remainder of the nodes within the nodal basin. Objective: To evaluate the accuracy of method in squamous cell carcinoma of larynx and com- pare neck status between Sentinel Node Biopsy (SNB) followed by Elective Neck Dissection (END) and SLNB alone. Results: Eighteen patients, 12 at glottis and in 6 supraglottis with a mean age of 63 years (49-83) were evaluated. The follow-up was 64 months (48-87), sentinel node was identified in all the patients and it was positive in four patients (22%). Five patients (27%) received post- operative radiotherapy because of local factors such as: positive margin, vascular invasion, perineural invasion or extra-capsular spread. During the follow-up period none of the patients had local or neck recurrence (0%). In the last evaluation none of the patients had local or neck recurrence. Conclusion: Sentinel Node Biopsy (SNB) in larynx cancer shows negative predictive value of 100%, accuracy of 100% and recurrence rate of 0%. It is important to note that no randomized study of sufficient sample size and sensitivity exists in the literature, but preliminary studies shows a new perspective in head and neck cancer.