The role of computed tomography of the chest in the staging of early squamous cell carcinoma of the tongue

Abstract

Computed tomography (CT) of the chest is often used in the detection of simultaneous pulmonary disease in patients with carcinoma of the upper aerodigestive tract. The incidence has been reported to be between 0 and 21%, but most studies include new and recurrent disease, diverse tumour sites, and varying TN staging. Few report on the staging of newly diagnosed early squamous cell carcinoma (SCC) of the tongue (T1–T2, N0). With increasing awareness of cancer and improved public health education, this group may present more often in future. The aim of our study was therefore to establish the value of CT in the routine staging of these patients. We retrospectively reviewed the case notes of 52 patients (mean age 66, range 34–95) who presented with newly diagnosed early SCC of the tongue. Data were collected related to abnormalities found on spiral CT imaging of the chest, the action taken, and whether this influenced the definitive treatment. Two abnormalities were detected on CT (4%), and in neither case was it a simultaneous malignancy. The proposed definitive treatment was not affected by the imaging findings in either case. There is a low rate of simultaneous thoracic abnormalities in patients with early SCC of the tongue. This may justify further rationalisation of the routine use of CT of the chest.