Clinical significance of preoperative imaging in oral squamous cell carcinoma compared with lymph node status: a comparative retrospective study

Mazzawi, Elias; El-Naaj, Imad Abu; Ghantous, Yasmine; Balan, Salim; Sabo, Edmond; Rachmiel, Adi; Leiser, Yoav

doi:10.1016/j.oooo.2017.11.021

Cited by 2 publications

(1 citation statement)

References 39 publications

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“…More recently, analysis of the diagnostic accuracy of ultrasound in comparison with (1)(8) F-FDG-PET/CT, and fused (1)(8) F-FDG-PET-MR images with DWI for the detection of cervical lymph node metastases revealed the highest diagnostic sensitivity for ultrasound [ 22 ]. The impact of head and neck CT scans to identify occult lymph node metastasis is discussed controversially with respective sensitivities ranging from 48–100% [ 23 , 24 ]. Subsequently, our series demonstrated slight, but significant over-staging of N-status that refers most likely to pre-therapeutic combination of CT/MRI-scan and ultrasonographic examination of lymph node basin.…”

Section: Discussionmentioning

confidence: 99%

Bilateral versus ipsilateral neck dissection in oral and oropharyngeal cancer with contralateral cN0 neck

Knopf

Jacob

Bier

et al. 2020

Eur Arch Otorhinolaryngol

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Objective Contralateral elective neck dissection (cEND) in oral and oropharyngeal squamous cell cancer (OC/OPC) is still a matter of debate. The current study analyzed the outcome in OC/OPC patients with/without cEND. Methods OC/OPC patients (n = 471) were diagnosed with contralateral N0 after CT/MRI-scan combined with neck ultrasound. Clinico-pathological features were analyzed using Chi-square/Fisher exact/Student’s t test. Survival rates were calculated using Kaplan–Meier and log-rank test. Prognostic variables were evaluated by Cox regression. Primary/secondary endpoints were overall/recurrence-free survival (OS/RFS). Results Pre-therapeutic imaging revealed a significantly over-staged N-status (p = 0.01), while occult contra-lateral N + was diagnosed in one patient only (0.4%). OC patients did not show differences in OS/RFS between the groups (ipsi- vs. bi-lateral). There was a strong tendency towards a better OS in OPC patients who underwent ipsi-lateral ND (p = 0.07). Cox-regression demonstrated that only tumor recurrence was associated with a fivefold increased risk of recurrence-associated death (p < 0.0001) that referred to a significant higher recurrence rate at primary tumor site (rT +) and increased distant metastatic outgrowth in OPC who underwent bi-lateral neck dissection (p = 0.03). While RFS of any cause (rT + /rN + /rM +) was significantly better in OPC with ipsi-lateral ND (p < 0.05), RFS of contralateral lymph node recurrence (rN2c) was comparable in both groups. Conclusion END of the contralateral cN0 neck is not correlated by an increased RFS or OS. Standard imaging techniques including CT/MRI scan and neck ultrasound warrant watchful waiting for neck dissection of the contralateral cN0 neck.

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Section: Discussionmentioning

confidence: 99%