Sentinel Node Biopsy for Oral Cavity Cancer: Establishing the Workflow

PROGRAM DESCRIPTION: Sentinel node biopsy (SNB) is established as standard of care for breast cancer and melanoma. In oral cavity carcinoma, elective neck dissection is recommended due to an approximately 30% chance of occult nodal metastases. This means that greater than 2/3rds of patients undergoing elective neck dissection for oral cavity carcinoma have no evidence of nodal involvement on final pathology. SNB addresses this issue. SNB is widely used in Europe and parts of Asia for oral cavity carcinoma and has been adopted in select centers in the United States. It is supported by NCCN guidelines and continued advances in experience and technology predict that the use of SNB for oral cavity carcinoma will continue to grow. This topic is particularly timely as an international, multi-institutional randomized prospective clinical trial addressing the role of SNB in oral cavity cancer opened in July 2020 and is actively enrolling (NRG-HN006).

This expert series will focus on the role of SNB in the management of oral cavity carcinoma. This will be evidence-based with review of the major multi-institutional trials on the topic. The benefits and limitations will be reviewed, including perceived roadblocks that have slowed adoption in the United States. The experienced instructors will present the newest technology and techniques as well as tips for incorporation into practice. Special emphasis will be given to understanding the workflow and coordination required among multiple teams, including surgery, nuclear medicine, and pathology. Finally, the new multi-institutional NRG Oncology randomized trial designed to define the role of SNB in oral cavity cancer will be reviewed with discussion of how to be involved.