Document Detail


Correlation of histopathologic findings with clinical and radiologic assessments of cervical lymph-node metastases in oral cancer.
MedLine Citation:
PMID:  7782638     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The accuracy of preoperative diagnosis of cervical lymph-node metastasis in oral cancer was assessed by comparing the histopathologic findings in 136 sides of neck dissection with physical examination under anaesthesia (EUA) and computerized tomography (CT) assessments of the metastatic status. The overall accuracy of EUA and CT assessments was 72% and 73%, respectively, and a combination of both methods resulted in sensitivity and specificity rates of 55% and 78%, respectively. Twenty-three of the 51 histologically positive necks had been assessed as negative on both EUA and CT. Six of these contained only micro-metastases, and in another 10, the largest positive node was 1.5 cm or less. Extracapsular spread of metastatic carcinoma was found in 12 of the 23 EUA and CT false-negative dissections. Most of the 21 histologically positive necks which had been correctly assessed as positive on both EUA and CT contained enlarged metastatic nodes, fused nodal masses, extensive extracapsular spread, or more than one of these features. Three of the 85 histologically negative necks had been assessed as positive on both EUA and CT; eight had been positive on EUA alone, and another eight on CT alone. Reactive nodal hyperplasia or sialadenitis was seen in most false-positive dissections. We conclude that the accuracy of preoperative diagnosis of metastasis by routine methods remains poor, and that EUA and CT are reliable only in patients with bulky metastatic deposits.
Authors:
J A Woolgar; J C Beirne; E D Vaughan; H G Lewis-Jones; J Scott; J S Brown
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of oral and maxillofacial surgery     Volume:  24     ISSN:  0901-5027     ISO Abbreviation:  Int J Oral Maxillofac Surg     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-07-20     Completed Date:  1995-07-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8605826     Medline TA:  Int J Oral Maxillofac Surg     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  30-7     Citation Subset:  D; IM    
Affiliation:
Oral Diseases Unit, School of Dentistry, University of Liverpool, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anesthesia, General
Carcinoma, Squamous Cell / diagnosis,  secondary*
Chi-Square Distribution
Child
False Negative Reactions
False Positive Reactions
Female
Humans
Lymph Node Excision
Lymphatic Metastasis / diagnosis*
Male
Middle Aged
Mouth Neoplasms / pathology*
Neck / radiography,  surgery
Oropharyngeal Neoplasms / pathology*
Predictive Value of Tests
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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