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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(04): s00451809906
DOI: 10.1055/s-0045-1809906
Original Research

Cost Analysis of Sentinel Lymph Node Biopsy for Oral Tongue Squamous Cell Carcinoma: Institutional Cohort and Population-Based Simulation

Authors

  • Hugo Fontan Köhler 

    1   Department of Head and Neck Surgery and Otolaryngology, AC Camargo Cancer Center, São Paulo, SP, Brazil

  • Genival Barbosa de Carvalho 

    1   Department of Head and Neck Surgery and Otolaryngology, AC Camargo Cancer Center, São Paulo, SP, Brazil

  • José Guilherme Vartanian 

    1   Department of Head and Neck Surgery and Otolaryngology, AC Camargo Cancer Center, São Paulo, SP, Brazil

  • Luiz Paulo Kowalski 

    1   Department of Head and Neck Surgery and Otolaryngology, AC Camargo Cancer Center, São Paulo, SP, Brazil
    2   Department of Surgery, Universidade de São Paulo, São Paulo, SP, Brazil

Funding The author(s) received no financial support for the research.
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Abstract

Introduction

In oral carcinoma patients classified as cN0, selective neck dissection (SND) and sentinel lymph node biopsy (SLNB) may be used to stage the neck with equivalent oncological results.

Objective

Compare the costs of SLNB and SND for oral squamous cell carcinoma.

Methods

Analysis of institutional cohort and Markov chain model simulation using populational data.

Results

We included 84 patients submitted to transoral resection and SLNB or SND and patients submitted only to SND. The mean cost was R$4,943,67 for SLNB and R$ 11,005.49 for SND with significant differences in length of stay (one versus three days, p < 0.001), operative time (92 versus 177 minutes, p < 0.001) and postoperative hospital visits in 60 days (two versus eight, p < 0.001). For the simulation model, the probability of not finding the SLN ranged from 0.0% to 5.7% with 0.5% increments and the probability of occult neck metastasis ranged from 9.0% to 100.0% with 1% increments. The costs of SLNB increase progressively as the rate of occult neck metastasis increases. When this rate reaches 56%, the cost difference becomes not significant. With rates above 72%, SLNB becomes significantly more expensive than SND. Using a public database, we calculate a cost decrease ranging from 27.93% to 66.54% with SLNB adoption.

Conclusion

SLNB adoption may significantly decrease the costs associated with early-stage oral cancer treatment. It would allow more patients to be treated with the same number of resources now available.

Keywords

mouth neoplasms - lymphatic metastasis - neck dissection - cost analysis

Authors' Contributions

HFK: conceptualization, data curation, data analysis, writing – original draft; GBC: data curation, analysis review, writing – review & editing; JGV: data analysis, writing – review & editing; LPK: analysis review, writing – review & editing.


Data Availability Statement

Data supporting the results of this study are available upon a reasonable request from the corresponding author.




Publikationsverlauf

Eingereicht: 27. November 2022

Angenommen: 02. April 2023

Artikel online veröffentlicht:
16. Oktober 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Hugo Fontan Köhler, Genival Barbosa de Carvalho, José Guilherme Vartanian, Luiz Paulo Kowalski. Cost Analysis of Sentinel Lymph Node Biopsy for Oral Tongue Squamous Cell Carcinoma: Institutional Cohort and Population-Based Simulation. Int Arch Otorhinolaryngol 2025; 29: s00451809906.
DOI: 10.1055/s-0045-1809906