CERVICAL LYMPH NODE METASTASES IN HEAD & NECK MALIGNANCY -A CLINICAL /ULTRASONOGRAPHIC/ HISTOPATHOLOGICAL COMPARATIVE STUDY (original) (raw)
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47 Annals Surgical Oncology 2004
The aim was to determine the reliability and reproducibility of sentinel node biopsy (SNB) as a staging tool in head and neck squamous cell carcinoma (HNSCC) for T1/2 clinically N0 patients by means of a standardized technique.
Journal of Maxillofacial and Oral Surgery, 2010
Background The presence or absence of nodal metastasis has a great impact on the prognosis and survival of patients with head and neck cancer. The risk of occult metastasis is related to the method by which the lymph nodes are evaluated. It is possible to reduce the risk of undiagnosed metastasis with accurate imaging techniques and thus probably reduce the number of elective neck treatments. Aims and objectives To assess the accuracy of clinical palpation, CT Scan, Ultrasound and Ultrasound guided FNAC in prediction of lymph node metastasis in oral squamous cell carcinoma so that a suitable surgical neck dissection can be carried out. Methods Ten patients with oral squamous cell carcinoma who underwent 10 neck dissections (4 RND, 6 SOND) were included. All the patients underwent examination of neck pre operatively by palpation, Computed Tomography with contrast, Ultrasound and Ultrasound guided FNAC for no detection. The findings were correlated with the results of histopathologic examination of the neck specimen. The results were obtained after statistical analysis. Results Six neck dissection specimens showed metastatic lymph node involvement in postoperative histopathology. Lymph node involvement was identified preoperatively by palpation in 7 necks, CT in 3 necks, US in 9 necks and US-FNAC was positive in 4 cases. The palpation showed 83% sensitivity, 50% specificity. CT showed sensitivity of 50%, specificity of 100%, US showed sensitivity of 100%, specificity of 25% and US-FNAC showed sensitivity of 67%, specificity of 100%. Conclusion The palpation, CT Scan and US are equally accurate but the US-FNAC is the most accurate technique in assessing metastasis in lymph nodes in patients with oral squamous cell carcinoma.
National journal of maxillofacial surgery
Oral cancer is a major health threat in a country like India, where patients frequently present with advanced disease with regional dissemination to cervical lymph nodes. The management and prognosis depend on the status of cervical lymph nodes. Thus, it becomes imperative to diagnose and evaluate them preoperatively. This study aims to compare the efficacy of palpation, ultrasonography (USG) and computed tomography (CT) in the preoperative evaluation of cervical lymph node for metastasis in patients with oral squamous cell carcinoma. Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha, India. A total of thirty patients of either sex of age group 20-70 years, diagnosed with oral cancer were randomly selected for the study and subjected to palpation, USG and computer tomography followed by histopathology for confirmation. The results were evaluate statistically by sensitivity, specificity, positive predictive value, and negative predictive v...
International Journal of Clinical Oncology, 2011
Background Preoperative lymph node screening of all neck compartments is favored by clinicians for the management of the neck. The presence of a metastatic node on one side of the neck reduces the 5-year survival rate to 50%, and the presence of a metastatic node on both sides of the neck reduces the 5-year survival rate to 25%. Materials and methods This study compared the evaluation of lymph node metastases by ultrasonography (USG) and computed tomography (CT) in patients with squamous cell cancer of the head and neck region. Results Five hundred and eighty-four patients with squamous cell cancer of the head and neck were prospectively evaluated for the presence of cervical lymph node metastases. All patients underwent clinical examination (palpation), USG and CT imaging. Neck dissection was performed in all the patients, and the results of the preoperative evaluation were correlated with the surgical and histopathological findings. Metastases in neck nodes were identified in 148 patients by histopathological examination.
The Journal of Laryngology & Otology, 2002
The detection of cervical lymph nodal metastasis and carotid artery invasion by metastatic lymph nodes is an important issue in the management of head and neck malignancies. This study compared the evaluation of metastasis by palpation, ultrasonography (USG) and computed tomography (CT) in patients with known head and neck malignancies.Twenty-five consecutive patients with head and neck malignancy were prospectively evaluated for the presence of cervical lymphadenopathy and carotid artery invasion. All patients underwent clinical examination (palpation), USG and CT examination. A modified CT criteria was employed which yielded acceptable results for the detection of metastatic nodes. Radical neck dissection was performed for 26 neck sides, and the results of pre-operative evaluation were confirmed by the surgical and histopathological findings.Palpation, ultrasound and CT have comparable sensitivity in the determination of metastasis involving cervical lymph nodes. Thus palpation sh...
Arguments in Favor of Precautional Treatment of Cervical Nodes in Clinically N0 Oral Cancer
Tumori Journal, 1982
Our retrospective and unrandomized clinical study covers 317 squamous cell carcinomas of the oral cavity initially N0 and treated with curietherapy from January 1959 to December 1970. Upon conclusion of the treatment on T, a radical dissection of the neck was performed only on 110 patients (34.7%) and the other 207 were not submitted to surgery. The incidence of N0 N+ cases was 27.3% (30/110). The clinical evolution showed that in the group not submitted to radical dissection 53 of 179 cases (29.6%) with adequate follow-up had lymph nodal relapses; 15/69 of these were initially T1 (21.7%) and 38/110 initially T2,3 (34.5%). The data concerning clinical evolution and analysis of the survival curves for the 2 groups supply arguments in favor of the systematic treatment of the lymphatic areas of the neck in initially N0 oral carcinomas.
Elective neck dissection in early oral squamous cell carcinoma: necessary
Plastic and Aesthetic Research, 2016
Aim: The indication of neck dissection in oral squamous cell carcinoma (OSCC) is a problem of risk-benefit evaluation between probability of neck metastases, the problem of complications associated with neck dissection and the prognostic influence of delayed diagnosis of metastasis during follow-up. There is no consensus on the elective treatment of the neck in early oral cancer patients with a clinically N0 (cN0) neck. Methods: The author performed a search of PubMed articles with the words "elective neck dissection vs. observation", "node negative neck" and "early stage oral squamous cell carcinoma". The author selected those articles that studied the early OSCC (T1-T2), and elective neck treatment was compared with clinical observation. Results: Many studies have compared the outcome of elective neck dissection (END) to observation of the neck in early OSCC. The results of them are described. The biologic aggressiveness of oral cavity squamous cell carcinoma, particularly in the early stages, is reflected in its ability to metastasize to regional lymph node chains. Many pretreatment imaging techniques to diminish the incidence of occult metastases haven been studied, and comparative studies have shown ultrasound guided fine needle aspiration cytology (USgFNAC) to be the most accurate. Conclusion: A few non-randomized studies have shown no advantages of END when strict USgFNAC follow-up was employed. Thus, if routine strict follow-up using USgFNAC by a well-trained ultrasonographer cannot be assured, END is the safest strategy.