Page 82 - Sentinel lymph node biopsy in oral cavity cancer - Inne J. den Toom

Chapter 4 Reporting other risk factors may be useful to develop a nomogram selecting SLNB positive patients for neck dissection and active surveillance or wait and scan follow-up. Presence of more than one positive SLN, absence of negative SLNs (besides a positive SLN) and a positive SLN ratio of more than 50% may be predictive factors for non-SLN metastasis in SLNB positive patients. To this point, there is no well argued reason to refrain from an additional neck dissection based on these risk factors or tumor size in the SLN. The presented data support the use of a selective neck dissection, when because of a SLNB positive neck an additional neck dissection is indicated. 80