Novel techniques for sentinel node biopsy in head and neck cancer

Student thesis: Doctoral ThesisDoctor of Philosophy


The most important prognostic indicator in early cancer is whether the disease has metastasised to regional lymph nodes. Pre-operative imaging is not sensitive enough to detect micrometastatic deposits therefore most patients judged to have more than 20% risk of disease spread will have elective surgical removal of the draining lymph node basins in order to reduce the risk of leaving tumour behind. Such operations can be lengthy and associated morbidity can reduce the patient’s quality of life. In the majority of these elective nodal clearances histopathological analysis is clear of disease in the majority suggesting that the surgery could be omitted without affecting the patient’s disease free survival.
Sentinel node biopsy (SNB) is a surgical stating test in which the tumour draining lymph nodes can be thoroughly investigated for metastasis. If free of disease there is no indication to subject the patient to further surgery. SNB has been validated in oral cancer, but there is a false negative rate of up to 14%. Recent developments may improve the accuracy of the SNB test.
This work evaluated new sentinel node technologies (navigation surgery, fluorescence imaging, and improved tracer formulations) in oral cancer, and opened up new applications for the test in other head and neck cancers (salivary, thyroid and larynx). These refinements in sentinel node process may allow many patients suffering with early cancer to benefit from personalised staging and treatment.
Date of Award2018
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorMark McGurk (Supervisor) & Tony Ng (Supervisor)

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