Sentinel Lymph Node Biopsy in Clinically N0 Oral Squamous Cell Carcinoma:A Single-Center Experience with a Focused Review of Current Evidence

Background and Objectives: Accurate assessment of occult cervical metastasis is essential for determining the need for elective neck treatment in oral squamous cell carcinoma (OSCC). This study investigated the safety and clinical relevance of sentinel lymph node biopsy (SLNB) as a strategy to limit the extent of prophylactic neck surgery in patients with clinically N0 OSCC. Materials and Methods: Twenty-two patients diagnosed with clinically node-negative OSCC were retrospectively analyzed. Sentinel lymph nodes were localized using preoperative lymphatic mapping with scintigraphic imaging. Intraoperative frozen-section evaluation was performed, and diagnostic performance was determined by comparison with permanent histopathologic examination. Results: SLNB showed favorable diagnostic performance in this cohort, with a negative predictive value of 98.8%, although this estimate should be interpreted cautiously because of the small sample size. Management of the neck was guided by the presence or absence of metastatic involvement identified in sentinel lymph nodes among patients with early-stage disease and no clinical evidence of cervical metastasis. Conclusion: In this small single-center cohort, SLNB helped identify occult nodal metastasis in clinically N0 OSCC and may support individualized neck management in early-stage oral cancer.