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
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
