Sentinel node biopsy in the detection of cervical occult lymph node metastases in patients with parotid gland carcinoma.

In patients with carcinoma of the parotid gland the management of the
clinically negative neck is a controversial issue. In most patients a selective
(L I-III) neck dissection is performed but a substantial number of them are
futile. The current diagnostic techniques are not accurate enough to detect
occult lymph node metastases. The sentinel node procedure may be useful to
select patients for neck dissection and reduce the number of futile neck
dissections.

To evaluate the feasibility and prove the concept of sentinel node biopsy in
patients with carcinoma of the parotid gland and scheduled for parotidectomy
and elective neck dissection.

This is an observational non-randomized validation study. Patients will undergo
peritumoral injection of radiolabelled-colloid, lymphoscintigraphy, surgical
excision of the sentinel lymph node(s) in the neck and detailed
histopathological examination.

Sentinel node biopsy is a procedure which is used routinely in other tumor
types. In the literature on head and neck cancer no serious adverse events have
been reported using these techniques. Sentinel node biopsy will be performed by
experienced head and neck surgeons during surgery of the primary tumor. Neck
dissection in combination with sentinel node biopsy stages the neck more
accurately (by detecting micrometastases and single tumor cells which may be
missed during routine examination of lymph nodes) than neck dissection alone.
Findings from this validation study may have implications for future treatment
planning.