Accuracy of f<scp>ine‐needle</scp> aspiration cytology in detecting cervical node metastasis after radiotherapy: Systematic review and meta‐analysis

Costantino, Andrea; Mercante, Giuseppe; D'Ascoli, Elisa; Ferreli, Fabio; Tommaso, Luca Di; Franzese, Ciro; Giannitto, Caterina; Casale, Manuele; Spriano, Giuseppe; Virgilio, Armando De

doi:10.1002/hed.26536

Cited by 5 publications

(4 citation statements)

References 43 publications

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“…Crucially, the study elucidated that there were no significant differences in the diagnostic performance of these imaging modalities in assessing cervical LNM 43 . Another separate meta‐analysis conveyed that FNAC exhibited a sensitivity of 69.1% and a specificity of 84.2% in diagnosing cervical LNM, findings that align closely with the previously mentioned imaging modalities 45 . LS was reported to hold a sensitivity of 100.0%, a specificity of 81.25%, and an accuracy of 96.66% in the preoperative detection of cervical LNM in patients with OSCC 46 .…”

Section: Neck Management For Osccsupporting

confidence: 52%

“…43 Another separate meta-analysis conveyed that FNAC exhibited a sensitivity of 69.1% and a specificity of 84.2% in diagnosing cervical LNM, findings that align closely with the previously mentioned imaging modalities. 45 LS was reported to hold a sensitivity of 100.0%, a specificity of 81.25%, and an accuracy of 96.66% in the preoperative detection of cervical LNM in patients with OSCC. 46 However, it should be noted that this study was predicated on relatively small sample size, a factor that may potentially introduce significant bias.…”

Section: Preoperative Assessment Of Clnsmentioning

confidence: 98%

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Lymph node metastasis in oral squamous cell carcinoma: Where we are and where we are going

Cao

Zhong

et al. 2023

Clinical and Translational Dis

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BackgroundOral cancer is a common malignant tumour in the head and neck region, with over 90% of cases being oral squamous cell carcinoma (OSCC). Lymph node metastasis (LNM) is a significant adverse prognostic factor in OSCC; however, the mechanism of LNM in OSCC remains unclear, while the strategies for managing cervical lymph nodes (CLNs) in OSCC continue to evolve. At present, neck dissection is necessary for the vast majority of OSCC patients, but complications of surgery can significantly impair patients’ postoperative quality of life. A recent clinical trial discovery indicates that immunotherapy can activate anti‐tumour T cells in nearby lymph nodes, leading to vibrant discussions among clinicians about the importance of preserving lymph nodes during surgical treatment.AimThis review aims to provide an overview of where we are: the current knowledge of OSCC LNM patterns and management strategies, and where we are going: prospects for clinical and basic research on the issue of OSCC LNM in the era of cancer immunotherapy.ResultWe summarize the general patterns and management strategies of OSCC LNM. The process of LNM in OSCC encompasses four stages: Preparation, Unleash, Migration, and Planting (‘PUMP’ principle). We propose adopting the ‘PRECISE’ model, an overall workflow that includes seven elements—prevention, radiology, preoperative evaluation, chemotherapy, immunotherapy, surgery, and postoperative evaluation—for neck management in OSCC, promoting personalized precision medicine augmented by neoadjuvant therapy. We further discussed recent advances in clinical and basic research on OSCC LNM and provided an outlook on future research directions.ConclusionOver the past two centuries, our understanding and management strategies of LNM in OSCC have evolved, seeking more precise and personalized approaches to reduce patient burden and enhance survival and quality of life. Further research should explore lymph nodes’ role in cancer immunotherapy and OSCC interactions, leading to better, less invasive treatments and improved outcomes.

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Section: Neck Management For Osccsupporting

confidence: 52%

Section: Preoperative Assessment Of Clnsmentioning

confidence: 98%

Lymph node metastasis in oral squamous cell carcinoma: Where we are and where we are going

Cao

Zhong

et al. 2023

Clinical and Translational Dis

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“…163,1096 Ultrasound with fine needle aspiration cytology in the assessment of disease response cannot be relied upon in isolation. 1097 Other potential strategies in this situation that require more evaluation include diffusion-weighted imaging MRI, 1098 or the use of circulating biomarkers such as tumour DNA or HPV antigens to detect disease persistence. 1099 Currently, a therapeutic neck dissection is generally recommended in advanced N 3 HPV-positive or HPV-negative SCC with an equivocal response, because there is little evidence to modify the standard of care with a second, delayed PET-CT scan.…”

Section: Recommendationsmentioning

confidence: 99%

“…Ultrasound with fine needle aspiration cytology in the assessment of disease response cannot be relied upon in isolation. 1097 Other potential strategies in this situation that require more evaluation include diffusion-weighted imaging MRI, 1098 or the use of circulating biomarkers such as tumour DNA or HPV antigens to detect disease persistence. 1099…”

Section: Treatment Of Clinically Staged Node-positive Neckmentioning

confidence: 99%

Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition

Homer,

Winter,

Abbey

et al. 2024

J. Laryngol. Otol.

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Diffusion‐Weighted MRI for Recurrent/Persistent Head and Neck Squamous‐Cell Carcinoma After Radiotherapy: Systematic Review and Meta‐Analysis

Canali,

Costantino,

Mari

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo evaluate the accuracy of diffusion‐weighted magnetic resonance imaging (DWI‐MRI) in diagnosing persistent/recurrent head and neck squamous cell carcinomas (HNSCCs) after primary chemoradiotherapy (CRT).Data SourcesScopus, PubMed/MEDLINE, and Cochrane Library databases were searched for relevant publications until April 18, 2023.Review MethodsA systematic review and meta‐analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses of Diagnostic Test Accuracy statement. The search was conducted independently by 2 investigators. Methodological quality of included studies was assessed using the Quality Assessment of Diagnostic Studies‐2 questionnaire. Extracted data were used to calculate the pooled DWI‐MRI sensitivity, specificity, diagnostic odds ratio, and positive and negative likelihood ratio.ResultsA total of 618 patients from 10 studies were included for calculation of diagnostic accuracy parameters. At the level of the primary tumor, the pooled sensitivity and specificity were, respectively, 0.96 (95% confidence interval [CI]: 0.89‐1.00) and 0.81 (95% CI: 0.54‐0.98) in the case of qualitative analysis, and, respectively, 0.79 (95% CI: 0.66‐0.89) and 0.88 (95% CI: 0.77‐0.96) for quantitative analysis. At the level of the neck, the pooled sensitivity and specificity were, respectively, 0.87 (95% CI: 0.75‐0.95) and 0.84 (95% CI: 0.74‐0.93) when images were analyzed qualitatively, and 0.79 (95% CI: 0.60‐0.94) and 0.90 (95% CI: 0.82‐0.97) when analyzed quantitatively.ConclusionDWI‐MRI showed high diagnostic accuracy and should be considered if persistent/recurrent HNSCCs is suspected after primary CRT. No significant differences were found between qualitative and quantitative imaging assessment.

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Accuracy of fine‐needle aspiration cytology in detecting cervical node metastasis after radiotherapy: Systematic review and meta‐analysis

Cited by 5 publications

References 43 publications

Lymph node metastasis in oral squamous cell carcinoma: Where we are and where we are going

Lymph node metastasis in oral squamous cell carcinoma: Where we are and where we are going

Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition

Diffusion‐Weighted MRI for Recurrent/Persistent Head and Neck Squamous‐Cell Carcinoma After Radiotherapy: Systematic Review and Meta‐Analysis

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