Abstract
Purpose To evaluate the sensitivity and specificity of clinical examination for cervical lymph node metastasis in patients with floor of mouth (FOM) squamous cell carcinoma (SCC). Comparison will be made to published data on other modalities used to investigate cervical metastasis.Methodology A retrospective chart audit was conducted and 53 patients with FOM SCC were included in this cohort. Clinical examination was performed at the initial consultation and from this a TNM stage was established. This was compared to histology reports from operative specimens and the sensitivity and specificity for clinical examination calculated.Results Clinical examination alone for FOM cancer has a sensitivity and specificity of 72% and 77% respectively. The incidence of clinically occult disease in this cohort was 22%.Conclusion Failure to detect and treat occult cervical metastasis significantly affects recurrence and survival. Clinical examination alone failed to detect a significant percentage of cervical metastasis in this cohort. Radiological modalities may improve the detection of clinically occult disease. However, neck dissection and histological examination remains the ‘gold standard’ as a therapeutic and diagnostic tool.
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