Lymphoscintigraphy of the pretreated neck in head and neck squamous cell carcinoma

Treatment of lymph nodes is based on the knowledge that the pattern of
metastatic spread is predictable, and related to site, size and
histopathological status of the primary tumor. However, any disturbance of
normal drainage by operation, radiotherapy or recurrent disease, can result in
other pathways of lymphatic drainage with dissemination of cancer cells.
Lymphoscintigraphy is able to supply a complete map of the lymphatic drainage
and thereby tailoring treatment which may minimise the extent of under- and
overtreatment. If accessible the status of these sentinel lymph nodes can be
determined by histopathological examination of excised sentinel nodes (sentinel
node biopsy procedure) or (ultrasound guided) fine needle aspiration cytology
of these nodes.

To analyze the value of lymphatic mapping in HNSCC patients with a previously
treated neck.

This is an observational non-randomized single-institute pilot study.Injection
of radiolabeled-colloid prior or during anesthesia for endoscopy,
lymphoscintigraphy using a gamma camera and if possible (depending on the
localization) surgical excision of the sentinel lymph node(s) or (ultrasound
guided) fine needle aspiration cytology.

Lymphoscintigraphy and sentinel node biopsy and aspiration are procedures which
are used routinely in several tumor types. In the literature on head and neck
cancer no serious adverse events have been reported using these techniques.
Sentinel node biopsy and ultrasound guided fine needle aspiration cytology will
be performed by experienced head and neck surgeons, radiologist and
pathologist.