Abstract
To evaluate the diagnostic accuracy of contrast-enhanced computed tomography scan in detecting cervical nodal metastasis in oral cavity squamous cell carcinoma. The retrospective cross-sectional study was conducted at Aga Khan University Hospital, Karachi, Pakistan. and comprised records from January 1, 2015, to October 31, 2016, of patients diagnosed with oral cavity squamous cell carcinoma and who underwent surgical resection of primary tumour along with neck dissection after having a contrast-enhanced computed tomography scan of head and neck. Diagnostic accuracy of the scans was calculated using final histopathology as the gold standard. All scans were reviewed by a consultant radiologist. Data was analysed using SPSS 23. Of the 100 patients whose records were reviewed, 70(70%) were female, 55(55%) had buccal and 32(32%) had tongue cancer.. The scans had sensitivity 83%, specificity 61.7%, positive predictive value 70.9%, negative predictive value 76.3% and overall diagnostic accuracy 73%. Computed tomography scan was found to be a useful tool for preoperative staging of oral cavity squamous cell carcinoma. However, due to low specificity and negative predictive value, elective neck dissection should still be done in a negative scan for cervical lymph node metastases.
Highlights
Head and neck cancers are among the most common ones in the world.Squamous cell carcinoma (SCC) of the head and neck is the sixth most common malignancy worldwide and accounts for approximately 62,000 cases and 13,000 deaths annually in the United States [1]
computed tomography (CT) scans had sensitivity 83%, specificity 61.7%, positive predictive value (PPV) 70.9%, negative predictive value (NPV) 76.3% and overall diagnostic accuracy 73% (Table 3)
The current study found out CT sensitivity to 83%, specificity 61.7%, PPV
Summary
Squamous cell carcinoma (SCC) of the head and neck is the sixth most common malignancy worldwide and accounts for approximately 62,000 cases and 13,000 deaths annually in the United States [1]. They account for approximately onefifth (21%) of the cancers in males and about one-tenth (11%) in females. Histopathological assessment of surgical resection specimen remains important in post-operative management, and important prognostic markers include margin status, tumour size, tumour thickness, skin and bone involvement, and lympho-vascular invasion Among all these factors, affecting the prognosis, cervical lymph node metastasis is considered the most important and is used in staging the disease according to tumour, nodes and metastases (TNM)
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