Shannon S Wu, Noel F. Ayoub, Michelle M Chen, Andrey Finegersh, John B. Sunwoo, F. Holsinger, V. Divi, Fred M. Baik
2026.2.16HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
tlooto Summary
Compared costs of sentinel lymph node biopsy (SLNB) and END from the Medicare payer perspective, costs of SLNB were 10.6% less than END, and remained lower with completion ND rates ≤ 35%.
Abstract
BACKGROUND Elective neck dissection (END) is the standard treatment for early-stage oral cavity squamous cell carcinoma (OCSCC). This study compared costs of sentinel lymph node biopsy (SLNB) and END from the Medicare payer perspective.
METHODS Thirty-two patients with T1-2N0M0 OCSCC (16 SLNB and 16 END) treated at an academic institution from 2017 to 2025 were included.
RESULTS 32 patients were included: median age 62, 46.9% male, 38% had adjuvant RT. The SLNB cohort had shorter operative time and length-of-stay. Four patients had reoperations: 2 after SLNB (completion neck dissection, tumor re-resection) and 2 after END (neck hematomas). The SLNB cohort had lower costs for postoperative admission ($9567 vs. $12 920, p = 0.015). Total costs were not statistically different ($19 777 vs. $22 126, p = 0.45). On break-even analysis, SLNB with a completion ND rate ≤ 35% had lower costs than END.
CONCLUSIONS Costs of SLNB were 10.6% less than END, and remained lower with completion ND rates ≤ 35%.
Citation format
WU, Shannon S, et al. Cost comparison of sentinel lymph node biopsy versus elective neck dissection in early-stage oral cavity squamous cell carcinoma. HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2026, 48(7): 1804–1812.