Diagnostic efficacy of physical examination, preoperative ultrasound, and/or computed tomography in detecting lymph node metastasis: A single-center retrospective analysis of patients with squamous cell carcinoma of the head and neck

Zhang, Yi; Yu, Delin; Yang, Qian; Li, Wei

doi:10.1016/j.oooo.2022.05.002

Cited by 1 publication

(1 citation statement)

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“…LNs' size is the most discussed criterion for assessing cervical LNs metastasis, and there is a wide variation in the size of reactive and metastatic LNs; however, the challenge is the trade-off between sensitivity and specificity, which increases with decreasing size. Although various criteria have been proposed over the past few decades, however, none is perfect (25). Therefore, investigators incorporated LNs shape into the imaging criteria to improve the sensitivity of diagnosis (26).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram to predict cervical lymph node metastasis in head and neck squamous cell carcinoma

Chen,

Zhang,

et al. 2024

Front. Oncol.

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BackgroundHead and neck cancers are a heterogeneous, aggressive, and genetically complex collection of malignancies of the oral cavity, nasopharynx, oropharynx, hypopharynx, larynx, paranasal sinuses and salivary glands, which are difficult to treat. Regional lymph nodes metastasis is a significant poor prognosis factor for head and neck squamous cell carcinoma. Metastasis to the regional lymph nodes reduces the 5-year survival rate by 50% compared with that of patients with early-stage disease. Accurate evaluation of cervical lymph node is a vital component in the overall treatment plan for patients with squamous cell carcinoma of the head and neck. However, current models are struggle to accurately to predict cervical lymph node metastasis. Here, we analyzed the clinical, imaging, and pathological data of 272 patients with HNSCC confirmed by postoperative pathology and sought to develop and validate a nomogram for prediction of lymph node metastasis in patients with head and neck squamous cell carcinoma.MethodsWe retrospectively analyzed the clinical, imaging, and pathological data of 272 patients with head and neck squamous cell carcinoma (HNSCC) confirmed by postoperative pathology at the Affiliated Hospital of Qingdao University from June 2017 to June 2021. Patients were randomly divided into the training and validation cohorts in a 3:1 ratio, and after screening risk factors by logistic regression, nomogram was developed for predicting lymph nodes metastasis, then the prediction model was verified by C-index, area under curve (AUC), and calibration curve.ResultsOf the 272 patients, seven variables were screened to establish the predictive model, including the differentiation degree of the tumor [95% confidence interval(CI):1.224~6.735, P=0.015], long-to-short axis ratio of the lymph nodes (95%CI: 0.019~0.217, P<0.001), uneven/circular enhancement (95%CI: 1.476~16.715, P=0.010), aggregation of lymph nodes (95%CI:1.373~10.849, P=0.010), inhomogeneous echo (95%CI: 1.337~23.389, P=0.018), unclear/absent medulla of lymph nodes (95%CI: 2.514~43.989, P=0.001), and rich blood flow (95%CI: 1.952~85.632, P=0.008). The C-index was 0.910, areas under the curve of training cohort and verification cohort were 0.953 and 0.938 respectively, indicating the discriminative ability of this nomogram. The calibration curve showed a favorable compliance between the prediction of the model and actual observations. The clinical decision curve showed this model is clinically useful and had better discriminative ability between 0.25 and 0.9 for the probability of cervical LNs metastasis.ConclusionsWe established a good prediction model for cervical lymph node metastasis in head and neck squamous cell carcinoma patients which can provide reference value and auxiliary diagnosis for clinicians in making neck management decisions of HNSCC patients.

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Section: Discussionmentioning

confidence: 99%