Thin Serial Step Sectioning of Sentinel Lymph Node Biopsy Specimen May Not Be Necessary to Accurately Stage the Neck in Oral Squamous Cell Carcinoma

Bell RB, Markiewicz MR, Dierks EJ, Gregoire CE, Rader A. J Oral Maxillofac Surg. 2013 July.


The purpose of this study was to assess the predictability of sentinel lymph node biopsy (SNB) for oral squamous cell carcinoma (OSCC) when pathologic processing is performed without serial step sectioning.

Materials and Methods

We prospectively enrolled 36 patients with T1 or T2 cN0 OSCC into this institutional review board–approved prospective cohort study, and they underwent gamma probe–guided SNB in addition to selective neck dissection. The rate of patients with negative SNB results whose neck dissection was also negative for metastasis (negative predictive value) was the primary endpoint.


Of the 28 patients whose sentinel lymph nodes were found to be pathologically and clinically node negative by routine hematoxylin-eosin stain and immunohistochemistry, 27 were found to have no other pathologically positive nodes, corresponding to a negative predictive value of 96%.


The results of this study suggest that SNB performed without the use of thin serial step sectioning may accurately predict neck stage in OSCC.