Sentinel lymph node biopsy in lower lip cancer

Objective Lower lip SCC neck nodes metastases increase mortality to 50% of cases when involved. Recent NCCN guidelines don't refer to occult metastases investigation strategy. We report application and results of sentinel node biopsy as diagnostic method in cN0 lesions. Study Design Through the use of lymphoscintigraphy, performed with colloidal 99Tc injected in the main lesion, 22 patients with neck cN0 and negative ultrasonography were treated. Tumor staging varies from T1 (77,3%) to T4. Results Only two cases, both T2, result positive to micro metastases investigation, realized with monoclonal anti-body MNF 116 marking and 200μm microtome sections; either undergo to ND which allowed to identify respectively 1 pN+ each, same neck level of sentinel node. Conclusions To avoid needless elective neck dissection or a delay of treatment in occult N+ cases, biopsy method can identify metastases presence in cN0 cases, though we suggest expanding the method also to all T1 less than 1 cm.