Sentinel node navigation surgery as a diagnosis and treatment tool to find occult metastasis for early oral cancer

Although elective neck dissection （END） for early oral squamous cell carcinoma （OSCC） has low morbidity and mortality and is recommended as a treatment strategy, it is inevitable due to the nature of the procedure and many surgeries are performed unnecessarily. In Europe and the United States, sentinel node navigation surgery （SNNS） has been explored in clinical trials as a tool for managing early OSCC, which may help avoid unnecessary END. In Japan, we have encouraged the clinical use of SNNS in a domestic multi-institutional joint research. A phase Ⅲ randomized trial including 271 OSCC cases, which aimed to compare SNNS with END, found that the overall and disease-free survival rates did not differ, and the scores of neck functionality in the SNNS group were significantly better. It is anticipated that as the concept of SNNS becomes more widespread in the future, it will be necessary to subdivide micrometastases.