University College London Hospitals NHS Foundation Trust has become one of the first centres in the UK to introduce sentinel node biopsy (SNB) as a routine staging procedure for selected patients with early salivary gland cancer.
The innovative technique offers a less invasive way of determining whether cancer has spread to nearby lymph nodes and could help many patients avoid unnecessary major surgery.
Salivary gland cancers are rare cancers that develop in the glands that produce saliva. While surgery remains the main treatment, determining whether cancer has spread to lymph nodes in the neck is an important part of planning further care.
SNB identifies and removes only the first lymph node, or small group of lymph nodes, most likely to receive cancer cells if the disease has begun to spread. These nodes are then examined in the laboratory to determine whether cancer is present. If the sentinel node is free of cancer, patients may be able to avoid more extensive surgery to remove lymph nodes in the neck.
UCLH consultant head and neck surgeon Clare Schilling said: “Traditionally, many patients with early salivary gland cancer undergo an elective neck dissection to remove lymph nodes, despite only a minority having evidence of cancer spread.
“We estimate that the introduction of sentinel node biopsy could enable up to 80 per cent of suitable patients to avoid unnecessary major surgery and its associated side effects.”
The procedure involves injecting a small amount of radioactive tracer, blue dye, or both around the tumour site. The tracer travels through the lymphatic system in the same way that cancer cells would spread, allowing surgeons to identify the sentinel node. Typically, only one to three lymph nodes need to be removed and analysed.
Potential benefits for patients include:
- Less invasive surgery
- Reduced risk of nerve injury and shoulder dysfunction
- Shorter operations and hospital stays
- Faster recovery times
- More personalised treatment planning
The technique is already widely used in the management of several other cancers and has an established evidence base for accurately determining whether cancer has spread beyond the primary tumour.
In addition to reducing the need for unnecessary surgery, sentinel node biopsy can help clinicians identify unusual patterns of cancer spread that may otherwise be missed, improving the accuracy of cancer staging and supporting more tailored treatment decisions.
UCLH has extensive experience in the use of sentinel node biopsy for head and neck cancers and will prospectively monitor patient outcomes as the technique is introduced into routine practice for salivary gland tumours.
