Depth of invasion in patients with early stage oral cancer staged by sentinel node biopsy

I.J. den Toom, L.M. Janssen, R.J.J. van Es, K.H. Karagozoglu, B. de Keizer, S. van Weert, S.M. Willems, E. Bloemena, C.R. Leemans, R. de Bree

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Background: To investigate if depth of invasion (DOI) can predict occult nodal disease in patients with cT1‐2N0 (7th TNM) oral squamous cell carcinoma (OSCC) staged by sentinel lymph node biopsy (SLNB).
Methods: In 199 OSCC patients, DOI measurements and SLNB were performed.
Results: Metastases were found in 64 of 199 patients (32%). Of these 64 patients, the mean DOI was 6.6 mm compared to 4.7 mm in patients without metastases (P = .003). The ROC‐curve showed an area under the curve of 0.65 with a most optimal cutoff point of 3.4 mm DOI (sensitivity 83% and specificity 47%). Regional metastases were found in 15% of patients with DOI ≤ 3.4 mm.
Conclusion: DOI seems to be a poor predictor for regional metastasis in patients with cT1‐2N0 OSCC. Therefore, staging of the neck using SLNB in patients with early stage oral cancer should also be performed in tumors with limited DOI and probably in T3 (8th TNM) OSCC ≤4 cm diameter.

Original languageEnglish
Pages (from-to)2100-2106
Number of pages7
JournalHead and Neck
Issue number7
Early online date2019
Publication statusPublished - 1 Jul 2019


  • Oral cancer
  • depth of invasion
  • lymph node metastases
  • sentinel lymph node biopsy

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