Ultrasound guided fine needle aspiration cytology and sentinel node biopsy in the detection of occult lymph node metastases of early oral and oropharyngeal cancer

The treatment of the clinically negative neck (N0) in small oral or
oropharyngeal carcinoma is controversial. When there is a low likelihood of
occult (clinically undetectable) lymph node metastases, is the choice between
elective neck dissection or a wait and see policy. Because of the risk of over-
and undertreatment there is need for a reliable diagnostic technique.
Ultrasound guided fine needle aspiration cytology (USgFNAC) is routinely used
in the detection of lymph node metastases. The sentinel node procedure is a
promising technique which is nowadays routinely used in other tumor types.

Evaluation and comparison of sentinel node biopsy (SNB) and ultrasound guided
fine needle aspiration cytology (USgFNAC) in the management of the clinically
negative neck in patients planned for transoral excision of oral and
oropharyngeal squamous cell carcinoma.

Prospective, observational study of 60 patients to define accuracy of either
technique in a head-to-head comparison, and to model the cost effectiveness of
USgFNAC and/or SNB-based diagnosis-therapy combinations.
The volume and direct medical costs of treatment and follow-up will be
extracted from hospital databases and patient files. A model will evaluate the
costs and effects of possible diagnostic and treatment strategies in this
patient group.

Sentinel node procedure and ultrasound guided fine needle aspiration cytology
are used routinely in several tumor types. In the literature on head and neck
cancer no serious adverse events have been reported using these diagnostic
techniques. The diagnostic techniques will be performed by experienced head and
neck surgeons, nuclear physicians, radiologists and pathologists.