The use of radioisotope scans in the preoperative evaluation of epidermoid carcinoma of the head and neck.

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Abstract
Because of the growing awareness of metastatic disease in head and neck patients, a protocol including radioisotope scans was begun through the Baylor Department of Otolaryngology at the Houston V.A. Hospital in an attempt to identify these patients preoperatively. Out of 198 death charts reviewed, only 3 had positive preoperative scans and only one of these was clinically significant. Chest X-rays identified more preoperative metastatic disease than the radioisotope scans. Twenty percent of patients had second primaries, which was more than the number of patients dying with distant metastatic disease. Only 5% of these patients died of metastatic disease with local control. Local control with follow-up for second primaries should be the primary objective of the surgeon. Radioisotope scans were of no significant value in evaluating preoperative metastatic disease.