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Clinical utility and prospective comparison of ultrasonography and computed tomography imaging in staging of neck metastases in head and neck squamous cell cancer in an Indian setup

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Abstract

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. Doppler USG correctly identified 136 node-positive patients (n = 148; sensitivity 91.8%, specificity 97%). CT imaging correctly identified 122 patients with metastatic lymph nodes (n = 148; sensitivity 83%, specificity 93%). Positive predictive values of USG and CT imaging were 95.6% and 91.3%, respectively, whereas the negative predictive values of these two imaging studies were 95.4% and 89.6%, respectively.

Conclusions

The accuracy and sensitivity of USG in detection of cervical lymph node metastases make it a potentially promising and cheap preoperative tool for staging neck node metastases and optimizing the treatment plan for surgeons, especially in countries such as India.

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Acknowledgments

The authors thank Dr. S. Mandal Ph.D., for his help in statistical analyses. Thanks are due to Dr. Rizwana Ph.D., for helping in the preparation of manuscript.

Conflict of interest

The authors do not have any conflict of interests.

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Authors and Affiliations

  1. Department of Surgical Oncolgy, Chittaranjan National Cancer Institute (CNCI), 37, S P Mukherjee Road, Kolkata, 26, India

    Mohammad Ashraf, Jaydip Biswas, Jayesh Jha & Sandeep Nayak

  2. Department of Radiodiagnosis, Chittaranjan National Cancer Institute (CNCI), 37, S P Mukherjee Road, Kolkata, 26, India

    Suparna Majumdar

  3. Department of ENT and Head and Neck Surgery, Chittaranjan National Cancer Institute (CNCI), 37, S P Mukherjee Road, Kolkata, 26, India

    Vikas Singh, Anup Bhowmick & Aniruddha Dam

  4. Krishna Sudha Apartments, 28, Charu Avenue, Kolkata, 33, India

    Mohammad Ashraf

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  1. Mohammad Ashraf
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Correspondence to Mohammad Ashraf.

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Ashraf, M., Biswas, J., Jha, J. et al. Clinical utility and prospective comparison of ultrasonography and computed tomography imaging in staging of neck metastases in head and neck squamous cell cancer in an Indian setup. Int J Clin Oncol 16, 686–693 (2011). https://doi.org/10.1007/s10147-011-0250-2

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  • DOI: https://doi.org/10.1007/s10147-011-0250-2

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