Tumor cells are actually detected in multiple localisation (blood, nodes) of non metastatic patients and it seems that in some cases their presence could be a prognostic factor (circulating tumor cells). The presence of tumor cells in the surgical drains was attested as a bad prognostic factor (pancreatic adenocarcinoma), but have never been studied in head and neck cancer. We studied such case for fourteen patients with head and neck epidermoid carcinoma and adenocarcinoma after neck dissection for metastatic adenopathy.

The Cellsearch^® system uses immunomagnetic and fluorescence approaches for identification and detection of CTC. A total of fourteen patients were enrolled in this study: twelve of them for a HNSCC and two for a cervical metastasis of an adenocarcinoma. In the absence of detection kit for head and neck cancer, we used the CellSearch Epithelial Cell Kit Fluorescent reagents included acid nucleic staining (DAPI), anti-cytokeratin to detect epithelial cells and anti-CD45 antibodies for leukocyte exclusion.

No Disseminated Tumor Cells were found for four patients (31 %). A positive result was obtained for the nine other patients (69 %). Among these nine patients, two were T2N2M0 (3–242 DTC/5mL) and seven were T4N0-3M0 (7-2094 DTC/5mL). In the two cases of adenocarcinoma tumor cells were detected, demonstrating a different morphology compared to epidermoid carcinoma.

Tumor cells can be present in the neck after dissection, both in epidermoid carcinoma and in adenocarcinoma. The significations of this presence have to be determined and could influence perisurgical and post-operative treatments.