Preoperative ultrasonography for evaluation of clinically N0 neck in oral cavity carcinoma

Publication date: Available online 21 December 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Angel Rollon-Mayordomo, Teresa Creo-Martinez, Yolanda Marin-Lapeira, Juan-Andres Rodriguez-Ruiz, Pedro Infante-Cossio
The aim of this study was to evaluate preoperative ultrasound criteria to detect lymph node (LN) cervical metastasis in patients with clinically node-negative neck (cN0) oral cavity squamous cell carcinoma (OCSCC). A prospective, single-center, observational study was conducted in 90 patients undergoing cancer excision with or without elective neck dissection (END) between 2005 and 2012. A surgeon and an experienced radiologist performed preoperative cervical ultrasonography in all cases. The primary objective was to obtain an a priori sensitivity of 90% and specificity >50% in cN0 OCSCC staging. The sonographic criteria for LN assessment were as follows: number; neck levels; clusters; aspect; heterogeneity; longitudinal diameter (L); transverse diameter (T); L/T ratio; and combination in series or in parallel of T and L/T ratio. The gold standard for comparison was the LN histological identification of metastasis after END or the occurrence in the follow-up at least 36 months. Statistically significant sonographic criteria in univariate analysis (P<0.05) were as follows: multilevel lymph nodes, T diameter >6.5 mm, and the combination T>6.5 mm or L/T<1.3 ratio; and in multivariate logistic regression analysis were (P<0.05): combination T>6.5 mm and L/T<1.3 ratio, LN in level II, and moderately-poorly differentiated OCSCC. By using selected sonographic criteria, ultrasound can be a valid preoperative diagnostic method to optimize staging cervical metastasis and to help decide about neck dissection.



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