Diagnostic utility of central node necrosis in predicting extracapsular spread among oral cavity squamous cell carcinoma

ABSTRACT Background Oral cavity squamous cell carcinoma (SCC) represents the most common SCC affecting the head and neck region. Long‐term survival of patients with oral cavity SCC is adversely affected by lymph node metastasis and further decreased by the presence of lymph node extracapsular spread...

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Published in:Head & neck 2015-01, Vol.37 (1), p.92-96
Main Authors: Randall, Derrick R., Lysack, John T., Hudon, Marc E., Guggisberg, Kelly, Nakoneshny, Steven C., Wayne Matthews, T., Dort, Joseph C., Chandarana, Shamir P.
Format: Article
Language:English
Subjects:
Adult
Carcinoma, Squamous Cell - diagnosis
Carcinoma, Squamous Cell - surgery
extracapsular spread
Female
head and neck
Humans
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Lymphatic Metastasis - diagnosis
Male
Mouth Neoplasms - diagnosis
Mouth Neoplasms - surgery
Neck
Neck Dissection
Necrosis - diagnostic imaging
Necrosis - pathology
oral cavity
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
squamous cell carcinoma
Tomography, X-Ray Computed
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Summary:ABSTRACT Background Oral cavity squamous cell carcinoma (SCC) represents the most common SCC affecting the head and neck region. Long‐term survival of patients with oral cavity SCC is adversely affected by lymph node metastasis and further decreased by the presence of lymph node extracapsular spread (ECS). Methods Using a case‐control design, preoperative CT scans from patients with oral cavity SCC and metastatic lymphadenopathy were evaluated by 2 independent neuroradiologists, blinded to the study, for a number of radiologic parameters, including central node necrosis. Multivariate logistic regression was used to identify parameters independently predicting pathologic ECS. Results For both neuroradiologists, central node necrosis was a significant predictor of ECS, with high interrater agreement (kappa = 0.71). On multivariate analysis, only central node necrosis independently predicted ECS (odds ratio [OR] = 12.1; 95% confidence interval [CI] = 1.24–119). Central node necrosis predicted ECS with 91% sensitivity and 88% negative predictive values. Conclusion Our findings suggest that central node necrosis on preoperative CT scans is strongly associated with the presence of ECS. © 2014 Wiley Periodicals, Inc. Head Neck 37: 92–96, 2015
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.23562