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Diagnostic utility of central node necrosis in predicting extracapsular spread among oral cavity squamous cell carcinoma
Author(s) -
Randall Derrick R.,
Lysack John T.,
Hudon Marc E.,
Guggisberg Kelly,
Nakoneshny Steven C.,
Wayne Matthews T.,
Dort Joseph C.,
Chandarana Shamir P.
Publication year - 2015
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23562
Subject(s) - medicine , necrosis , lymph node , logistic regression , odds ratio , head and neck cancer , head and neck squamous cell carcinoma , confidence interval , multivariate analysis , epidermoid carcinoma , basal cell , carcinoma , radiology , pathology , cancer
Background Oral cavity squamous cell carcinoma (SCC) represents the most common SCC affecting the head and neck region. Long‐term survival of patients with oral cavity SCC is adversely affected by lymph node metastasis and further decreased by the presence of lymph node extracapsular spread (ECS). Methods Using a case‐control design, preoperative CT scans from patients with oral cavity SCC and metastatic lymphadenopathy were evaluated by 2 independent neuroradiologists, blinded to the study, for a number of radiologic parameters, including central node necrosis. Multivariate logistic regression was used to identify parameters independently predicting pathologic ECS. Results For both neuroradiologists, central node necrosis was a significant predictor of ECS, with high interrater agreement (kappa = 0.71). On multivariate analysis, only central node necrosis independently predicted ECS (odds ratio [OR] = 12.1; 95% confidence interval [CI] = 1.24–119). Central node necrosis predicted ECS with 91% sensitivity and 88% negative predictive values. Conclusion Our findings suggest that central node necrosis on preoperative CT scans is strongly associated with the presence of ECS. © 2014 Wiley Periodicals, Inc. Head Neck 37 : 92–96, 2015