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Reliability of the pre-operative imaging to assess neck nodal involvement in oral cancer patients, a single-center study

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Reliability of the pre-operative imaging to assess neck nodal involvement in oral cancer patients, a single-center study

dc.contributor.author	Pakkanen, Antti L	es
dc.contributor.author	Marttila, Emilia	es
dc.contributor.author	Apajalahti, Satu	es
dc.contributor.author	Snäll, Johanna	es
dc.contributor.author	Wilkman, Tommy	es
dc.date.accessioned	2023-06-16T08:36:47Z
dc.date.available	2023-06-16T08:36:47Z
dc.date.issued	2022	es
dc.identifier.citation	Pakkanen, AL., Marttila, E., Apajalahti, S., Snäll, J., & Wilkman, T. (2022). Reliability of the pre-operative imaging to assess neck nodal involvement in oral cancer patients, a single-center study. En Medicina Oral Patología Oral y Cirugia Bucal (pp. e191-e197). Medicina Oral, S.L. https://doi.org/10.4317/medoral.25228	es
dc.identifier.uri	https://hdl.handle.net/10550/88116
dc.description.abstract	Primary sites for the metastasis of oral cancer are the cervical lymph nodes. Although there has been considerable technical advancement in the radiological imaging, capability to recognize all metastatic lymph nodes pre-operatively has remained as a challenge. Thus elective neck dissection (END) has remained as reliable practice to treat cervical lymph nodes. This study evaluated the accuracy of pre-operative imaging in pre-operative diagnostics of cervical lymph node status using computed tomography or magnetic resonance imaging in patients with oral squamous cell carcinoma (OSCC). We have also considered the reasons for the difficulties to recognise metastatic nodes in cervical area. Patient charts of patients who had had elective neck dissection as a treatment for primary OSCC in the Department of Oral and Maxillofacial Surgery, Helsinki University Hospital between 2016 and 2017 were assessed retrospectively. The outcome variable was post-operatively histologically confirmed lymph node metastasis in the neck area. The primary predictor variable was radiologically confirmed metastasis in the neck area. The explanatory variables were age, sex, pT-class, imaging modality, delay and location of the tumour. Descriptive statistics, sensitivity, specificity and Youden-J index were computed. Eighty-three patients were included in the study. The sensitivity to detect pathological lymph nodes was 44.8%, and the specificity for the examination was 87.0%. 19.3% of cN0 patients had metastasis in the cervical nodes, whereas of the cN+ patients 8.4% were actually pN0. Patients having cN0, the largest neck metastasis was over 10 mm in 12.5%, whereas cN1-3 patients the corresponding rate was 45.5%. The computational threshold to diagnose a metastatic node was 7 mm. Especially small metastases are difficult to diagnose. Limitations of radiological diagnostics must be considered when treating OSCC.	es
dc.subject	odontogenic tumors	es
dc.subject	epidemiology	es
dc.subject	world health organization classification	es
dc.subject	oral pathology	es
dc.title	Reliability of the pre-operative imaging to assess neck nodal involvement in oral cancer patients, a single-center study	es
dc.type	journal article	es_ES
dc.subject.unesco	UNESCO:CIENCIAS MÉDICAS	es
dc.identifier.doi	10.4317/medoral.25228	es
dc.type.hasVersion	VoR	es_ES
dc.identifier.url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898583/