The clinical significant of pre-surgical imaging in oral squamous cell carcinoma compared with lymph node status: a comparative retrospective study
Publication date: Available online 11 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Elias Mazzawi, Imad Abu El-naaj, Yasmine Ghantous, Salim Balan, Edmond Sabo, Adi Rachmiel, Yoav Leiser
AimThe accuracy and sensitivity of commonly used imaging modalities in evaluating oral cavity cancer was evaluated by comparing the pre-surgical radiological findings and the post-surgical pathological report.MethodsOral squamous cell carcinoma patients, who had undergone at least one imaging test 2 weeks before the surgery, were included. Radiological findings were compared with the dissected neck to assess the lymph node status. Sensitivity and specificity of the imaging modalities were calculated using the Chi-square test.ResultsSensitivities for detecting metastatic neck lymph nodes at a threshold of 1cm were 48% (P = 0.02) and 43.8% (P = 0.3) for CT and MRI respectively. Specificities were 76.3% and 70% respectively. As for the 1.5cm threshold sensitivities were 36% (P = 0.002) and 31.3% (P = 0.5) respectively, and specificities were 91.5% and 76.7% respectively. PET-CT was the most sensitive modality in the present study, with a P value 0.02.ConclusionThe different studied imaging modalities used for pre-operational neck staging are not sensitive enough and would lead to underdiagnoses of a respectful proportion of patients. Thus prophylactic neck dissection for occult neck disease is of extreme importance and remains the gold-standard for oral cancer treatment.
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