Predictive value of computed tomography in identifying extracapsular spread of cervical lymph node metastases in p16 positive oropharyngeal squamous cell carcinoma.
Adult
Aged
Aged, 80 and over
Female
Head and Neck Neoplasms
/ diagnostic imaging
Humans
Lymph Nodes
/ diagnostic imaging
Lymphatic Metastasis
/ diagnostic imaging
Male
Middle Aged
Neck
Oropharyngeal Neoplasms
/ diagnostic imaging
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Squamous Cell Carcinoma of Head and Neck
/ diagnostic imaging
Tomography, X-Ray Computed
/ methods
computed tomography
extracapsular spread
extranodal extension
human papillomavirus
oropharynx
squamous cell carcinoma
Journal
Journal of medical imaging and radiation oncology
ISSN: 1754-9485
Titre abrégé: J Med Imaging Radiat Oncol
Pays: Australia
ID NLM: 101469340
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
04
10
2018
accepted:
24
03
2019
pubmed:
12
4
2019
medline:
8
2
2020
entrez:
12
4
2019
Statut:
ppublish
Résumé
Extracapsular spread (ECS) of lymph node metastases is associated with poor prognosis and is an indication for adjuvant chemoradiotherapy. Accurately identifying ECS using imaging may allow us to recommend primary chemoradiotherapy to avoid trimodality treatment. We investigated the accuracy of staging CT in diagnosing ECS in P16 + oropharyngeal squamous cell carcinoma (OPSCC). Patients with pathologically determined cervical nodal metastases from P16 + OPSCC were included. Two blinded radiologists scored images to predict the presence of ECS in comparison to histopathology. Eighty patients with a total of 91 specimens were evaluated. Pathologic ECS was identified in 53.8% of the patients. Sensitivity and specificity of CT for the two observers were 56.5% and 60.9%, and 73.3% and 66.7%, respectively. The presence of perinodal stranding was found to be significantly associated with pathological ECS. Computed tomography displays consistently high specificity, which may be used to rule out the presence of extracapsular spread in cervical nodal metastases of P16 + oropharyngeal squamous cell carcinoma.
Sections du résumé
BACKGROUND
BACKGROUND
Extracapsular spread (ECS) of lymph node metastases is associated with poor prognosis and is an indication for adjuvant chemoradiotherapy. Accurately identifying ECS using imaging may allow us to recommend primary chemoradiotherapy to avoid trimodality treatment. We investigated the accuracy of staging CT in diagnosing ECS in P16 + oropharyngeal squamous cell carcinoma (OPSCC).
METHODS
METHODS
Patients with pathologically determined cervical nodal metastases from P16 + OPSCC were included. Two blinded radiologists scored images to predict the presence of ECS in comparison to histopathology.
RESULTS
RESULTS
Eighty patients with a total of 91 specimens were evaluated. Pathologic ECS was identified in 53.8% of the patients. Sensitivity and specificity of CT for the two observers were 56.5% and 60.9%, and 73.3% and 66.7%, respectively. The presence of perinodal stranding was found to be significantly associated with pathological ECS.
CONCLUSION
CONCLUSIONS
Computed tomography displays consistently high specificity, which may be used to rule out the presence of extracapsular spread in cervical nodal metastases of P16 + oropharyngeal squamous cell carcinoma.
Identifiants
pubmed: 30973213
doi: 10.1111/1754-9485.12888
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
500-509Informations de copyright
© 2019 The Royal Australian and New Zealand College of Radiologists.