Ultrasound and fine needle aspiration cytology in the staging of neck lymph nodes in oral squamous cell carcinoma

• Published in: British journal of oral & maxillofacial surgery 2000-10, Vol.38 (5), p.430-436
• Main Authors: Hodder, S.C., Evans, R.M., Patton, D.W., Silvester, K.C.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Biopsy, Needle - instrumentation; Biopsy, Needle - methods; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Dentistry; Ent. Stomatology; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis; Medical sciences; Mouth Neoplasms - diagnostic imaging; Mouth Neoplasms - pathology; Mouth Neoplasms - radiotherapy; Mouth Neoplasms - surgery; Neck; Neck Dissection; Neoplasm Recurrence, Local - epidemiology; Neoplasm Staging; Otorhinolaryngology. Stomatology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Radiotherapy, Adjuvant; Sensitivity and Specificity; Treatment Outcome; Tumors; Ultrasonography, Interventional - instrumentation; Ultrasonography, Interventional - methods; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1054/bjom.2000.0332

We prospectively studied 49 patients with oral squamous cell carcinoma (SCC) who had their cervical regional lymph nodes examined by ultrasound (US), with or without fine needle aspiration cytology (FNAC), for the detection of metastatic spread. They were screened over a two-year period (1993–1995) by computed tomography (CT) and magnetic resonance imaging (MRI) or both to measure the primary tumour. US, with or without FNAC, was used to stage the neck. All tumours were biopsied preoperatively and the diagnosis of SCC conformed by histological examination. Management of the neck was based on US staging. Thirty-five patients had neck dissections and 14 were managed conservatively. Mean follow-up was 30 months (range 24–48). All patients were alive at one year, but one died at 14 months from recurrence of disease in the neck. There were 3 false negatives (6%). We find that US, with or without FNAC, is an accurate (86%), sensitive (92%) and specific (83%) technique for the preoperative assessment of lymph node metastases in patients with SCC.