Background: Sentinel node biopsy (SNB) is a potential procedure to change our current management principle of the cN0 neck in head and neck cancer. The aim of this study was to assess the long-term results of sentinel node navigation surgery (SNNS) in a tertiary medical center in Taiwan. Methods: We conducted a primary prospective study including patients presenting with cN0 oral squamous cell carcinoma (SCC) who underwent SNB or SNNS between January 2013 and March 2014. Detailed procedures of SNB and SNNS are described, and long-term results of the recruited patients are analyzed for patients with positive and negative SNB results. Results: One female (9%) and ten male patients (91%) were enrolled, and their ages ranged from 37 to 87 years old (mean: 54 ± 11 years) with a median follow-up of 2.3 years. Positive metastatic SNs were discovered in four patients (36%) during the operations. All of the patients with occult metastatic nodes were diagnosed with sentinel lymph node (SLN) mapping. The sensitivity was 100%, and the total operation time ranged from 60 minutes to 300 minutes (median: 120 minutes). The median operation time for negative and positive SNB was 120 min and 280 min, respectively (p < 0.01, Mann-Whitney test). Conclusions: SNB is a reliable procedure to identify occult neck metastasis for cN0 oral SCC. However, the operation time for SNNS varies from 60 min to 300 min for negative and positive SLNs, respectively. The unpredictable operation time may hinder the intention of the surgeon to perform this procedure.
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