Lymph node metastasis detection using light reflectance spectroscopy

Head and neck squamous cell carcinoma (HNSCC) has a high propensity to
metastasize to cervical lymph nodes (LN). This is associated with a markedly
reduced survival. The management of patients with a clinically negative neck
(cN0) is still a controversial issue. One policy is to surgically treat all
patients with a neck dissection (ND). This prevents occult metastases becoming
advanced but also implies over treating many patients. Another option is to
actively monitor the cN0 neck. The existing techniques to do this, however, all
have limitations in detecting small metastatic deposits. A possible solution
for the management of cN0 necks is to perform a sentinel node biopsy. If the
sentinel node contains malignant cells, a ND is recommend. Currently this ND is
done in a second (staged) procedure as histopathologic examination of the
sentinel node takes time. Single fiber reflectance spectroscopy (SFR) has the
potential to significantly reduce the number of second stage surgery by
in-vivo, immediate detection of metastases in the sentinel node. LN with
metastases undergo physiological changes that can be detected by SFR. A
previous similar study showed very promising results in mediastinal LN in
patients with lung cancer. In this study we would like the first step towards
using SFR to detect metastases in sentinel LN in patients with HNSCC. We will
do this by investigating if SFR can accurately discriminate metastatic cervical
LN from non-metastatic LN.

To accurately differentiate between metastatic and non-metastatic lymph nodes
using light reflectance spectroscopy.

Observational non-randomized cohort study.

The spectroscopy measurements will be performed while patients are under
general anesthesia. Measurements will be performed in vivo on tissues that will
be excised regardless of this study. The patients will not benefit from the
study.