Table 1.
cN0 Management | No. of Surgical Procedures | Per 100 cN0 Patients | |
---|---|---|---|
pN0 Undergoing Neck Dissection | pN+ Without Neck Dissection | ||
Watchful waiting | One | 0 | 30 |
Elective neck dissection | One | 70 | 0 |
Sentinel mapping (IHC)17* | Two (if N+) | 0 | 3 |
Sentinel mapping (PCR)18† | One | 5 | 4 |
Microarray12‡ | Two | 41 | 4 |
NOTE. Based on 30% of cN0 as pN+.
Abbreviations: cN0, clinical stage N0; IHC, immunohistochemistry; OSCC, oral squamous cell cancer; N+, node positive; NPV, negative predictive value; PCR, polymerase chain reaction; pN+, nodal metastasis found by pathology.
Based on 96% NPV for step-sectioning and IHC, and assuming no false-positive pathology reports.
Based on 86% sensitivity and 93.3% specificity for PCR compared with consensus pathology.
Based on Figure 3B; only one surgery would be required if microarray technology can be adapted to biopsy specimens.