Koos Boeve

66 Chapter 3 cT1-2N0 OSCC than the current clinical and pathological markers. In addition, it would be interesting to study the prognostic value of OSCC lymph node status associated biological markers such as WISP1 , RAB25 or EpCAM in cT1-2N0 OSCC SLNB staged patients [36-38]. Study limitations Limitation of this study is that the SLNB procedure was not part of the standard workflow for cT1-2N0 OSCC patients in the first years after introduction. If we analyse the accuracy without the 6 patients from this period, the sensitivity and NPV are still 85% and 94% respectively. CONCLUSION In this retrospective well-defined cohort consisting of 91 patients we showed that the sentinel lymph node biopsy is an accurate diagnostic technique in detecting occult metastases in cT1-2N0 OSCC and is a save and reliable alternative to an END or watchful waiting.