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ORIGINAL ARTICLE
Year : 2022  |  Volume : 6  |  Issue : 1  |  Page : 12-16

Sentinel lymph node biopsy using methylene blue alone in an era of significance of the depth of invasion in oral cancers: A prospective study


Centre for Oncology, Government Royapettah Hospital, Government Kilpauk Medical College, Chennai, Tamil Nadu, India

Correspondence Address:
Prof. Subbiah Shanmugam
Centre for Oncology, Government Royapettah Hospital, Government Kilpauk Medical College, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aiao.aiao_14_21

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Aim: To evaluate the accuracy of methylene blue dye alone in identifying sentinel nodes in oral cancers with clinically N0 neck and the significance of the depth of invasion (DOI) in combination with sentinel lymph node (SLN) biopsy in predicting nodal metastasis. Methods: This is a prospective study done over 24 months accruing 67 patients with cN0 neck admitted to our center for oncology. SLN harvesting was done adhering to the standard procedure using methylene blue dye for all early-stage oral cavity cancers with N0 neck clinically. Data were collected, grouped, and analyzed for deducing DOI, sensitivity, specificity, positive predictive value, and negative predictive value of the procedure and compared with other studies in the literature. Results: Out of 67 patients, males (76.1%) outnumbered female (23.9%) patients. The mean age of the patients was 51.5 years. Tongue (61.2%) was the most common site. Sentinel nodes were identified in 89.5% of patients. The mean number of Sentinel nodes identified was 1.9. The mean DOI was 7.3 mm. SLNs were most commonly identified in Level I (78.3%). Sensitivity, specificity, positive predictive value, and negative predictive value and accuracy deduced in this study were 75%, 97.9%, 90%, 94%, and 93.3%, respectively. Conclusion: Methylene blue dye alone can be successfully used for SLN identification in clinically node-negative oral cavity cancers, particularly with less DOI. DOI alone for predicting nodal involvement can be used with caution. Combination of DOI and sentinel node biopsy may help in better identification of nodal involvement.


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