Koos Boeve

14 Chapter 1 Sentinel lymph node biopsy procedure in early stage (cT1-2N0) OSCC Now the sentinel lymph node biopsy (SLNB) procedure is extensively used in breast cancer and melanomas, it was also introduced in head and neck cancer as a less invasive procedure for neck staging compared to the END [26]. The SLNB procedure enables detection and harvesting of the sentinel lymph nodes (SLNs) (Figure 2). Figure 2. Lymphatic drainage patterns in oral cancer. Oral cancer (marked in RED) metastasizes first by lymphatic drainage patterns to cervical located lymph nodes (marked in GREEN and PURPLE). The first lymph nodes in such lymphatic drainage patterns are called sentinel lymph nodes (SLN, marked in PURPLE). These SLNs are normally the first locations positive for metastasis. [Copyright © Koos Boeve, UMCG, 2019 Groningen] Since distant metastasis is reported in 6% to 12% of the OSCC cases [13,27,28], especially in those with advanced lymph node involvement (i.e. extranodal extension, ≥pN2), the SLN status indicates whether or not the tumour has metastasized regionally or to distant