Novel diagnostic modalities for assessment of the clinically node-negative neck in oral squamous-cell carcinoma

• Published in: The lancet oncology Vol. 13; no. 12; pp. e554 - e561
• Main Authors: Leusink, Frank KJ, van Es, Robert JJ, de Bree, Remco, de Jong, Robert J Baatenburg, van Hooff, Sander R, Holstege, Frank CP, Slootweg, Piet J, Brakenhoff, Ruud H, Takes, Robert P
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2012; Elsevier Limited
• Subjects: Biopsy; Business metrics; Cancer; Carcinoma, Squamous Cell - pathology; Dissection; Hematology, Oncology and Palliative Medicine; Humans; Lymphatic Metastasis - diagnosis; Metastasis; Morbidity; Mouth Neoplasms - pathology; Neck; Sentinel Lymph Node Biopsy; Transcriptome; Ultrasonic imaging
• ISSN: 1470-2045; 1474-5488; 1474-5488
• DOI: 10.1016/S1470-2045(12)70395-9

Oral squamous-cell carcinomas arise in mucosal linings of the oral cavity and frequently metastasise to regional lymph nodes in the neck. The presence of nodal metastases is a determinant of prognosis and clinical management. The neck is staged by palpation and imaging, but accuracy of these techniques to detect small metastases is low. In general, 30–40% of patients will have occult nodal disease and will develop clinically detectable lymph-node metastases when the neck is left untreated. The choice at present is either elective treatment or careful observation followed by treatment of the neck in patients who develop manifest metastases. These unsatisfying therapeutic options have been the subject of debate for decades. Recent developments in staging of the neck, including expression profiling and sentinel lymph-node biopsy, will allow more personalised management of the neck.